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Original research
Safety and efficacy of drug coated balloon angioplasty for intracranial atherosclerotic disease
  1. Hanzi Qiao1,
  2. Chien-Hung Chang2,
  3. Alvin Yi-Chou Wang3,
  4. Shaoxue Li4,
  5. Weilin Yang5,
  6. Guoming Li6,
  7. Xuecheng Cen4,
  8. Rongfei Wang7,
  9. Hao Lin8
  1. 1Neurology, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, China
  2. 2Neurology, Chang Gung Memorial Hospital Linkou Branch, Gueishan, Taoyuan, Taiwan
  3. 3Department of Neurosurgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, China
  4. 4Neurosurgical Department, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, China
  5. 5Brain Center, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, China
  6. 6Neurology Department, Second Clinical Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
  7. 7Department of Neurology, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, China
  8. 8Neurological Department, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, China
  1. Correspondence to Professor Alvin Yi-Chou Wang, Department of Neurosurgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong 510120, China; alvinfree{at}icloud.com

Abstract

Background Drug coated balloon (DCB) angioplasty can provide sustained anti-restenotic efficacy without the limitations of permanent vascular implantation and is presumably ideal for treating intracranial atherosclerotic disease. However, the safety of paclitaxel in the neurovasculature remains a concern.

Methods 242 patients with angiographically verified symptomatic stenosis >70% in intracranial arteries treated with DCB angioplasty were reviewed divided into two groups: group A, patients with stenotic intracranial arteries; and group B, patients with acute, subacute, or chronic occluded intracranial arteries. The primary endpoint was any stroke or death within 30 days. The secondary endpoint was arterial restenosis of >50% during follow-up.

Results 16 major and 12 minor complications occurred among 245 procedures (6.5% and 4.9%, respectively). Five patients died within 30 days after the procedure (2.1%, 5/242). 12 major and 12 minor complications occurred among 211 procedures in group A (5.7% and 5.7%). In group B, four major complications occurred among 34 procedures (11.8%). Hyperperfusion and perforator stroke accounted for half of all complications (53.6%, 15/28). Restenosis >50% was present in eight lesions during the follow-up period (4.8%, 8/167).

Conclusions After treatment with DCB angioplasty, complications were no different from those after standard balloon angioplasty or stenting. This study suggests that DCB angioplasty may be a safe and effective procedure for intracranial arterial stenosis.

  • Complication
  • Angiography
  • Atherosclerosis
  • Balloon

Data availability statement

Data sharing not applicable as no datasets generated and/or analyzed for this study.

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Data availability statement

Data sharing not applicable as no datasets generated and/or analyzed for this study.

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Footnotes

  • Twitter @freealvin

  • Contributors AY-CW and C-HC started the treatment regimen. HQ, SL, WL, GL, XC, RW, and HL joined force in the clinical study. AY-C W is responsible for the overall content of the study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Author note AY-C W is responsible for the overall content of the study.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.