Purpose

Endovascular therapy (EVT) represents an alternative treatment modality for symptomatic intracranial high-grade atherosclerotic stenosis (sICAS); however, periprocedural complication rates as well as midterm restenosis rates represent relevant limitations of EVT. Drug-coated balloon percutaneous transluminal angioplasty (DCB-PTA) may overcome some of these shortcomings. The aim of this study was to assess feasibility and safety as well as the stroke recurrence rate in 33 patients.

Methods

A retrospective, monocentric cohort study of sICAS patients treated with DCB-PTA. Outcome measures were the periprocedural intracranial complication rate, the recurrent stroke rate and mortality during follow-up.

Results

This cohort study included 33 patients with 35 sICAS treated with DCB-PTA. The median age was 72 years (interquartile range, IQR 66–77 years); median clinical and mean radiological follow-up time was 9 months (IQR 3–22 months). Median preprocedural degree of stenosis (WASID) was 80% (IQR 73–80%) and median postprocedural residual stenosis degree (WASID) was 50% (IQR 33–60%). Intracranial periprocedural complications occurred in 2 (6%) patients. The overall restenosis rate was 15% (n = 5). In four patients a symptomatic ischemic re-event occurred within 7 months after the initial treatment. None of the patients died.

Conclusion

This DCB-PTA cohort study showed a relatively low intracranial complication rate of 6% with a symptomatic recurrence rate of 12%. Larger trials are needed to validate these promising observations.

中文翻译：

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有症状的颅内高度狭窄的药物涂层球囊治疗：33 名患者的回顾性研究。

目的

血管内治疗 (EVT) 是有症状的颅内高度动脉粥样硬化狭窄 (sICAS) 的替代治疗方式；然而，围手术期并发症发生率以及中期再狭窄率代表了 EVT 的相关局限性。药物涂层球囊经皮腔内血管成形术 (DCB-PTA) 可以克服其中一些缺点。本研究的目的是评估 33 名患者的可行性和安全性以及卒中复发率。

方法

一项对接受 DCB-PTA 治疗的 sICAS 患者的回顾性、单中心队列研究。结果指标是围手术期颅内并发症发生率、卒中复发率和随访期间的死亡率。

结果

该队列研究包括 33 名接受 DCB-PTA 治疗的 35 名 sICAS 患者。中位年龄为 72 岁（四分位距，IQR 66-77 岁）；中位临床和平均放射学随访时间为 9 个月（IQR 3-22 个月）。中位手术前狭窄程度 (WASID) 为 80% (IQR 73-80%)，中位手术后残余狭窄程度 (WASID) 为 50% (IQR 33-60%)。2 名（6%）患者发生了颅内围手术期并发症。总体再狭窄率为 15% ( n  = 5)。4 名患者在初始治疗后 7 个月内再次出现症状性缺血事件。没有一个病人死亡。

结论

该 DCB-PTA 队列研究显示颅内并发症发生率相对较低，为 6%，症状复发率为 12%。需要更大规模的试验来验证这些有希望的观察结果。