Table 3

Technical comparison of PTAS of postirradiated carotid stenosis between DEB and conventional groups

DEB groupConventional groupComments
AnesthesiaGeneralLocalThe balloon-inflation time of PADEB is approximately 30–60 s. Patients under local anesthesia may sometimes be intolerant to severe bradycardia and cerebral ischemia during the procedure
Guiding sheath
6690 cm, Shuttle guiding sheath (Cook Medical)
Embolic protection device (FilterWire Ez)190/300 cm190 cmRanger’s DEB is an over-the-wire system for peripheral vessels which accommodates a 300 cm FilterWire EZ (Boston Scientific Co.). For the coronary monorail system of AGENT DEB (Boston Scientific Co.), we used 190 cm FilterWire EZ
Pre-dilatation balloonCoronary or peripheral balloon system (EMERGE or Sterling balloon, Boston Sci Co.).Coronary or peripheral balloon system (EMERGE or Sterling balloon, Boston Sci Co.).The pre-dilatation balloon was approximately 80–100% diameter of the adjacent normal segment
DEBYesNoneAs DEB is not used to dilate the lesions of PIRCS, we use a diameter of DEB the same as that of the pre-dilatation balloon. A peripheral DEB (Ranger) can provide adequate balloon length and diameter to cover the multisegmental, long lesions and unusual location of PIRCS (such as in CCAs). In cases of more than 95% stenosis or cases with near occlusion, we used the coronary DEB (AGENT, Boston Sci Co.) to prevent overdilatation of the target artery and to reduce the risk of hyperperfusion syndrome
Post-dilatation balloonNoneConditionalTechnical success was defined as <30% residual stenosis on control DSA. For the patients with PIRCS >95% or near occlusion, we did not perform post-dilatation to reduce the risk of hyperperfusion syndrome
  • CCAs, common carotid arteries; DEB, drug-eluting balloon; PADEB, primary angioplasty with drug-eluting balloon; PIRCS, postirradiated carotid stenosis; PTAS, percutaneous angioplasty and stenting.