Drug-coated balloon in the treatment of in-stent restenosis of the vertebrobasilar artery:an application study / 中华放射学杂志

ABSTRACT

Objective:To evaluate the safety, feasibility and efficacy of drug-coated balloon (DCB) in the treatment of in-stent restenosis (ISR) of the vertebrobasilar artery.Methods:Twenty-one patients with ISR of the vertebrobasilar artery treated with DCB at the Zhengzhou University People′s Hospital from January 2018 to December 2020 were retrospectively included. There were 22 lesions with ISR, of which 8 were located in the initial segments of vertebral artery, 12 were located in the V4 segment of the vertebral artery, and 2 were located in the basilar artery. The clinical prognosis was evaluated by modified Rankin Scale (mRS), and the target vessel restenosis was evaluated by DSA, CTA or MRA. The safety, feasibility and effectiveness of DCB in the treatment of vertebrobasilar artery ISR were analyzed by perioperative complications, technical success rate and follow-up.Results:All 21 patients with ISR underwent successful interventional surgery. No stroke, TIA and death occurred in perioperative period. During the operation, two cases (9.5%) were treated with Apollo stent due to the residual stenosis>50% after DCB dilation. The technical success rate was 90.5%. The mean stenosis of the target vessel was improved immediately from preoperative (78.1±11.3)% to postoperative (22.1±8.3)%. All the 21 patients were followed up. As of the last follow-up in September 2021, the median clinical follow-up period was 19 (12, 33.5) months, and there were no stroke, TIA and death caused by the corresponding artery. The mRS score was 0 in 18 patients 1 in 2 patients and 2 in 1 patient. Imaging follow-up was available in 13 cases (61.9%) with a median follow-up time of 7(5.5, 19) months, and the target vessel restenosis rate was 7.7% (1/13).Conclusions:This preliminary study has shown that DCB in the treatment of ISR of the vertebrobasilar artery is safe and feasible, with a high technical success rate and low restenosis rate, which provides clinical application evidence, but the long-term effect needs further follow-up observation.