Cutting Balloon Angioplasty for Carotid In-Stent Restenosis: Case Reports and Review of the Literature

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1552-6569.2007.00225.x Byline: Qaisar A. Shah (1), Alexandros L. Georgiadis (1), M. Fareed K. Suri (1), Gustavo J. Rodriguez (1), Adnan I. Qureshi (1) Keywords: Carotid artery; in-stent restenosis; cutting balloon angioplasty; transluminal angioplasty; carotid stent Abstract: ABSTRACT Percutaneous stenting techniques are becoming more commonly used for treatment of carotid artery disease. One outcome of particular concern is in-stent restenosis. Indications for treatment of in-stent restenosis are not clearly defined. Use of traditional balloon angioplasty with or without stent placement is still considered the first option. Cutting balloon angioplasty has recently been used as an alternative treatment option for revascularization of in-stent restenosis with higher procedural success rates and without the use of additional stents. We report our experience with cutting balloon angioplasty in treating 2 patients with carotid in-stent restonosis, and review previous cases reported in the literature. A total of 16 patients have been treated with cutting balloon angioplasty. Among 11 patients for whom the clinical and angiographic information were available, 63% of patients were asymptomatic at the time of treatment, and more than 90% of patients showed either complete angiographic resolution or residual stenosis of less than 30%. Additional stent placement or angioplasty was required in only half of the patients, and 1 patient had recurrent stenosis. The review suggests that the procedure is safe and effective. Author Affiliation: (1)From the Zeenat Qureshi Stroke Research Center, Department of Neurology, University of Minnesota, Minneapolis, MN (QAS, ALG, MFKS, GJR, AIQ) Article History: Acceptance: Received September 27, 2007, and in revised form September 27, 2007. Accepted for publication November 9, 2007. Article note: Correspondence: Address correspondence to Qaisar A. Shah, MD, University of Minnesota, Department of Neurology, MMC 295, 420 Delaware Street SE Minneapolis, MN 55455. E-mail: qaisarshah@gmail.com