O-029 Self-expanding stent versus drug-eluting balloon-expandable stent for intracranial arterial stenosis

We report the results of transcranial ultrasound monitoring in three patients with intracranial arterial stenosis of the middle cerebral artery treated with the only drug-eluting balloon certificated for intracranial use in highly symptomatic intracranial arterial stenosis, ELUTAX “3” (AR Baltic Medical). We performed transcranial Doppler ultrasounds 24 h, 72 h, 10 days, 15 days and 30 days after the angioplasty, thereby measuring mean flow velocity (MFV) in the maximum stenosis area in patients with symptomatic steno-occlusive disease of the middle cerebral artery treated with ELUTAX “3”. Two patients were treated during mechanical thrombectomy (MT) due to acute ischemic stroke and one patient was treated on elective basis due to symptomatic pre-occlusive stenosis, with recurrent transient ischemic attacks (TIAs) refractory to medical therapy. In Case 1, the first transcranial Doppler ultrasounds evidenced MFV of 348 cm/s, with progressive MFV reduction until 15 days post-treatment, with MFV of 177 cm/s. In Case 2, 24 h after angioplasty had an MFV of 258 cm/s, decreasing to 103 cm/s at 30 days. Case 3 had an MFV of 436 cm/s before angioplasty that immediately decreased after the procedure to 364 cm/s, with a final MFV of 260 cm/s at 30 days. We have recorded a progressive MFV reduction in intracranial arterial stenosis, with better outcomes in patients treated during MT. In our experience, the use of ELUTAX “3” for the treatment of symptomatic intracranial arterial stenosis achieves a progressive improvement of stenosis, evident in the first weeks, to a higher extent in cases of occlusive thrombosis. More studies are needed to provide more information about this device.

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Think Aspirin for Intracranial Arterial Stenosis

Clinical Psychiatry News ◽

10.1016/s0270-6644(05)70460-4 ◽

2005 ◽

Vol 33 (6) ◽

pp. 60-61

Author(s):

MICHELE G. SULLIVAN

Keyword(s):

Arterial Stenosis ◽

Intracranial Arterial Stenosis

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Drug-eluting Balloons in Coronary Artery Disease – Current and Future Perspectives

European Cardiology Review ◽

10.15420/ecr.2012.8.1.56 ◽

2012 ◽

Vol 8 (1) ◽

pp. 56 ◽

Cited By ~ 1

Author(s):

Anouar Belkacemi ◽

Pierfrancesco Agostoni ◽

Michiel Voskuil ◽

Pieter Doevendans ◽

Pieter Stella ◽

...

Keyword(s):

Small Vessel Disease ◽

Percutaneous Treatment ◽

Added Value ◽

High Concentration ◽

Diffuse Disease ◽

Stent Restenosis ◽

Alternative Treatment Option ◽

Drug Eluting ◽

Drug Eluting Balloon ◽

In Stent Restenosis

Percutaneous treatment of complex coronary lesions, such as small-vessel disease, diabetes and long diffuse disease, remain hampered by suboptimal results, even with the use of drug-eluting stents (DES). The paclitaxel drug-eluting balloon (DEB) is an interesting emerging device that optimises clinical outcomes in these specific lesions. The DEB may become a viable alternative treatment option for the inhibition of coronary restenosis and subsequent revascularisation, as it allows local release of a high-concentration antirestenotic drug, paclitaxel, into the coronary vessel without using a metal scaffold or durable polymers. Several studies have already shown promising and consistent results in the treatment of in-stent restenosis. The DEB has demonstrated its added value compared with certain DES. Inspired by these results, an increasing number of studies have been started in different coronary lesion subsets to explore the value of the DEB in a broader range of lesions. It will be interesting to see whether the DEB will find more indications beyond in-stent restenosis treatment. Moreover, will all DEBs offer the same added value, or will there be differences in efficacy among the DEBs produced by the various manufacturers? As was the case in the development of DES, now the puzzle pieces have to be put together for DEB.

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