Long-term lumen area enlarged in coronary in-stent restenosis after the treatment of paclitaxel drug-coated balloon dilatation
10.3969/j.issn.1008-794X.2017.04.020
- VernacularTitle:紫杉醇药物涂层球囊扩张冠状动脉支架内再狭窄病变增加远期管腔面积
- Author:
Rong LIU
;
Shixin MA
;
Gang ZHAO
;
Jingyu HANG
;
Meng WEI
;
Zhigang LU
- Keywords:
drug-coated balloon;
in-stent restenosis;
long-term lumen area enlargement
- From:
Journal of Interventional Radiology
2017;26(4):367-369
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of paclitaxel drug-coated balloon (DCB) dilatation in treating coronary in-stent restenosis (ISR) occurring after drug-eluting stent (DES) implantation,and to observe the long-term changes of the target vascular lumen area in order to clarify the curative effect of paclitaxel DCB in treating ISR.Methods Four patients with ISR whose clinical condition met the DCB indication were selected.According to the standard process,sufficient pre-expansion of ISR was performed first,then paclitaxel DCB dilatation was carried out to dilate the lesion segment of ISR,and no stent was implanted.Both coronary angiography and intravascular ultrasound (IVUS) were performed immediately after the treatment as well as 9 months to measure the minimum lumen area (MLA) and cross-sectional area (SA) of the stent,and the intimal hyperplasia was also been evaluated.Results In all 4 patients,angiography performed immediately after paclitaxel DCB dilatation showed that neither dissection of the dilated segment of the target artery nor obvious residual stenosis was observed.Angiography performed 9 months after the treatment revealed that all dilated segments of the target arteries were patent,and no pronounced restenosis of stent segment was seen.IVUS examination was indicated that MLA became enlarged,SA showed an increasing trend,and intimal hyperplasia showed a tendency to be inhibited.Conclusion For the treatment of ISR,pure paclitaxel DCB dilatation can obtain long-term lumen area enlargement,thus,repeated stent implantation can be avoided,which,in turn,can reduce the risk of ISR recurrence.Paclitaxel DCB dilatation can locally release paclitaxel,which has curative effect on the coronary artery wall to inhibit the excessive proliferation of intima.