Clinical study of drug-coated balloon in the treatment of symptomatic intracranial atherosclerotic stenosis
10.3760/cma.j.cn112149-20220518-00450
- VernacularTitle:药物涂层球囊治疗症状性颅内动脉粥样硬化性狭窄的临床研究
- Author:
Yingkun HE
1
;
Yao TANG
;
Wenbo LIU
;
Liangfu ZHU
;
Ziliang WANG
;
Wenli ZHAO
;
Yanyan HE
;
Yao ZHAO
;
Tianxiao LI
Author Information
1. 郑州大学人民医院介入中心脑血管病科 河南省人民医院卒中中心神经外科 河南大学人民医院脑血管病中心 河南省神经介入研发与应用工程研究中心 河南省脑血管病国际联合实验室 河南省脑血管介入创新工程技术研究中心，郑州 450003
- Keywords:
Radiology, interventional;
Intracranial arteriosclerosis;
Drug-coated balloon
- From:
Chinese Journal of Radiology
2023;57(2):194-200
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the safety and efficacy of drug-coated balloon (DCB) in the treatment of symptomatic intracranial atherosclerotic stenosis.Methods:Forty-nine patients with symptomatic intracranial atherosclerotic stenosis treated with DCB in the People′s Hospital of Zhengzhou University from January 2018 to August 2021 were retrospectively included. The location and number of lesions were as follows: 21 cases of the middle cerebral artery, 11 cases of the intracranial segment of vertebral artery, 12 cases of the basilar artery, and 5 cases of the intracranial segment of internal carotid artery. Pre-dilatation of the lesion with a normal balloon followed by DCB angioplasty. Clinical follow-up (outpatient or telephone) was carried out at 30 days, 3 months, 6 months, and 1 year after the operation. Imaging follow-up was carried out at 6 months postoperatively. The surgical success rate (defined as the proportion of patients with residual stenosis<50% after balloon dilatation), perioperative safety (any strokes, TIA, and deaths within 1 month), stroke recurrence, and restenosis were analyzed.Results:The operation was performed in all patients successfully. The median stenosis level was 80% (75%, 85%) preoperatively and 20% (15%, 30%) at the time after the operation. The success rate of the operation was 91.8% (45/49). Stenting was given in 11 cases (22.4%, 11/49) for severe flow-limiting vascular entrapment, or non-flow-limiting entrapment, owing to the concern of subsequent progression of the entrapment. Three cases (6.1%, 3/49) had significant vascular elastic retraction and implement stent implantation. One patient (2.0%, 1/49) developed symptomatic cerebral infarction during perioperative period, and the symptoms improved after treatment. No fatal or disabling stroke occurred. All patients were followed-up successfully. The median follow-up time was 12 months. Two patients (4.1%, 2/49) had a stroke in the responsible vascular area, and 1 (2.0%, 1/49) patient had a stroke in the non-responsible vascular area. Thirty-eight patients (77.6%, 38/49) had followed-up images. The median follow-up time of postoperative imaging was 6 months. Restenosis occurred in two cases (1 case had symptomatic restenosis), and the incidence of restenosis was 5.3% (2/38).Conclusions:DCB in the treatment of symptomatic intracranial atherosclerotic stenosis has a high technical success rate, good perioperative safety, and low stroke recurrence rate in short-term follow-up, demonstrating the good feasibility, safety, and efficacy of DCB.
