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1
Tranggono Yudo Utomo. "ANGIOPLASTY UNTUK STENOSIS ATEROSKLEROSIS INTRAKRANIAL." Jurnal Kedokteran Universitas Palangka Raya 9, no. 2 (2021): 1318–25. http://dx.doi.org/10.37304/jkupr.v9i2.3511.
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Stenosis Aterosklerosis Intrakranial (ICAS) adalah penyebab umum Transient Ischemic Attack (TIA) dan stroke iskemik yang merupakan penyebab kematian nomor dua di dunia. Hingga 40 - 50%, tingkat ICAS simptomatik secara signifikan lebih tinggi pada populasi Asia dan mungkin merupakan penyebab paling umum dari stroke di seluruh dunia. Indikasi untuk perawatan endovaskular merupakan tantangan dan pemilihan bahan serta teknik intervensi pada dasarnya berbeda dari pengobatan stenosis ekstrakranial. Prosedur konservatif (perubahan medis dan gaya hidup) dan terapi endovaskular serta pendekatan terapi endovaskular (angioplasti balon perkutan (PTA) atau angioplasti stent-assisted (PTAS)) tersedia untuk perawatan ICAS. Tinjauan pustaka ini bertujuan untuk menevaluasi peran angioplasty sebagai tatalaksana dari stenosis aterosklerosis intrakranial. Perawatan endovaskular, seperti balloon angioplasty dengan atau tanpa stenting, telah muncul sebagai pilihan terapeutik untuk stenosis intrakranial simtomatik. Ada banyak jenis teknik endovaskular yang tersedia untuk perawatan ICAS, termasuk balloon angioplasty, ballon – mounted stent (Pharos Vitesse), dan self – expandable stent (Wingspan), masing-masing memiliki fitur dan keunggulan spesifik yang berkaitan dengan lesi arteri intrakranial yang berbeda. Maka dari itu, terapi endovascular pada pasien ICAS dapat dipertimbangkan sebagai alternatif untuk mencegah TIA/stroke iskemik berulang. Tindakan endovaskular membutuhan pertimbangan yang komprehensif dan persiapan multidisiplin agar dapat memberikan pelayanan yang efektif untuk pasien.
 Kata Kunci : Stenosis Aterosklerosis Intrakranial, Angioplasty, Aterosklerosis Intrakranial, Stenosis Intrakranial
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Takase, Yukinori, Tatsuya Tanaka, Satoshi Anai, et al. "Usefulness of non-slip element percutaneous transluminal angioplasty scoring balloons in treating severe calcified lesions of the carotid artery for carotid artery stenting: A case report." Surgical Neurology International 15 (March 15, 2024): 91. http://dx.doi.org/10.25259/sni_923_2023.
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Background: Treatment of calcified lesions with conventional angioplasty balloons can be difficult due to insufficient lumen expansion, high dissection rates, and repeated revascularization. We report a case in which a scoring balloon was used in lesions resistant to angioplasty with a semi-compliant balloon. Case Description: A 72-year-old man presented with severe stenosis and a highly calcified lesion in the right cervical internal carotid artery. Right carotid artery stenting (CAS) was planned to prevent future ischemic stroke events. Conventional semi-compliant balloon angioplasty was unsuccessful. Three inflations of a non-slip element (NSE) percutaneous transluminal angioplasty (PTA) scoring balloon (Nipro, Osaka, Japan) successfully achieved CAS without complications. Conclusion: This is the first report to describe the use of this scoring balloon in de novo carotid artery disease. NSE PTA scoring balloon catheters can be a useful option for refractory, highly calcified stenosis.
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Werner, Martin. "Angioplasty with drug coated balloons for the treatment of infrainguinal peripheral artery disease." Vasa 45, no. 5 (2016): 365–72. http://dx.doi.org/10.1024/0301-1526/a000552.
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Abstract. Restenosis or re-occlusion after femoropopliteal angioplasty or stent implantation is the main limitation of endovascular treatment strategies for peripheral artery disease. Within the last years, balloon catheters with anti-proliferative drug coating on the balloon surface have shown to be associated with higher patency rates compared to plain balloon angioplasty. Thus, drug-coated balloons were gradually adopted in many interventional centres for the treatment of femoropopliteal obstructions. The current review summarises the existing evidence for drug-coated balloons in the infrainguinal vessels and their indication in special lesion cohorts.
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Kitrou, Panagiotis, Konstantinos Katsanos, Georgia Andriana Georgopoulou, and Dimitrios Karnabatidis. "Drug-Coated Balloons for the Dysfunctional Vascular Access: An Evidence-Based Road Map to Treatment and the Existing Obstacles." Seminars in Interventional Radiology 39, no. 01 (2022): 056–65. http://dx.doi.org/10.1055/s-0042-1742483.
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AbstractAn underlying stenosis within the venous limb of a hemodialysis access circuit is the main etiology for graft and fistula dysfunction as well as other symptoms such as arm, breast, and neck swelling. Treatment options for both peripheral and central venous stenoses include plain old balloon angioplasty, angioplasty with drug-coated balloons, and stenting. This article discusses the current evidence for the use of drug-coated balloon angioplasty in this patient population.
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Miley, Jefferson T., Nauman Tariq, Fotis G. Souslian, et al. "Comparison Between Angioplasty Using Compliant and Noncompliant Balloons for Treatment of Cerebral Vasospasm Associated With Subarachnoid Hemorrhage." Operative Neurosurgery 69, suppl_2 (2011): ons161—ons168. http://dx.doi.org/10.1227/neu.0b013e31822a8976.
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Abstract BACKGROUND Considerable controversy exists regarding the choice of balloon used for performing angioplasty as treatment of cerebral vasospasm associated with subarachnoid hemorrhage. OBJECTIVE To determine the impact of compliant and noncompliant balloons on angiographic and clinical outcomes among patients with subarachnoid hemorrhage–related cerebral vasospasm. METHODS Consecutive patients with cerebral vasospasm who underwent balloon angioplasty were included. Patient characteristics, rate of angiographic recurrence, and occurrence of cerebral infarcts in the affected vessel distribution were compared between arteries treated using different balloons. RESULTS A total of 30 patients underwent a first-time angioplasty using compliant (n = 34) or noncompliant (n = 51) balloons. At admission, patients were classified Hunt and Hess grade I to III (n = 20) and Hunt and Hess grade IV to V (n = 10). Fisher grades in patients were I (n = 1), II (n = 3), III (n = 20), and IV (n = 6). No significant differences in the rate of angiographic recurrence (32% vs 53%; P = .14), need for repeat angioplasty (21% vs 20%; P = .97), and occurrence of cerebral infarcts in the affected arterial distribution (21% vs 10% P = .39) were observed with compliant and noncompliant balloons, respectively. Independent of the balloon type, a significant reduction in the need for repeat angioplasty was observed when the initial angioplasty resulted in a normal or supranormal diameter compared with a subnormal diameter (63.5% vs 36.5%; P = .01). CONCLUSION No clear difference was observed between compliant and noncompliant balloons for therapeutic angioplasty in preventing angiographic recurrence or the need for repeat angioplasty in patients with subarachnoid hemorrhage–related cerebral vasospasm. An immediate normal or supranormal vessel diameter after the first-time angioplasty resulted in a significant reduction in the need for repeat angioplasty.
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Ko, Seien, Jin Komuro, Yoshinori Katsumata, et al. "Peripheral pulmonary stenosis with Noonan syndrome treated by balloon pulmonary angioplasty." Pulmonary Circulation 10, no. 4 (2020): 204589402095431. http://dx.doi.org/10.1177/2045894020954310.
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Noonan syndrome is known to have various cardiovascular defects, which include pulmonary artery stenosis. Pulmonary artery stenosis is characterized by obstruction of pulmonary artery blood flow that can cause elevated pulmonary artery pressure and ventilation-perfusion inequality, which can cause dyspnea on exertion and eventually, heart failure. Although the etiology of pulmonary artery stenosis related to congenital diseases is still unknown, balloon pulmonary angioplasty has being reported to be effective to selected patients with Alagille and Williams syndromes, but not from Noonan syndrome despite of modest prevalence of pulmonary artery stenosis. Here, we report the first Noonan syndrome patient with pulmonary artery stenosis who underwent successful balloon pulmonary angioplasty. The strategy used in balloon pulmonary angioplasty was planned with careful morphologic evaluation by computed tomographic angiography, and performed with scoring balloons in a graded approach with multiple sessions. After balloon pulmonary angioplasty, we confirmed maintained dilation of lesions and symptom alleviation, suggesting that balloon pulmonary angioplasty can be performed safely on pulmonary artery stenosis in a Noonan syndrome patient.
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Murata, Ryohei, Yo Kamiizumi, Tsutomu Haneda, et al. "Retrieval strategy for ruptured balloon with circumferential tear during angioplasty for arteriovenous fistula in hemodialysis patients." Journal of Vascular Access 21, no. 2 (2019): 246–50. http://dx.doi.org/10.1177/1129729819870634.
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Introduction: Balloon angioplasty is a common endovascular procedure. The balloon for angioplasty sometimes ruptures (incidence, 3.6%–10%), and it is constructed such that it ruptures in a longitudinal direction and complications related to rupture are rare. However, on rare occasions, retrieval is challenging, especially in the case of ruptures with a circumferential tear. There is no established method for retrieval and careful retrieval is required due to the risk of embolization by the residual balloon fragment. Technique: We describe two cases of balloon rupture in the transverse direction during percutaneous transluminal angioplasty for arteriovenous fistula in hemodialysis patients. In these cases, the balloon ruptured with a circumferential tear and dissected into two parts, and the tip edge remained in the vessel. We inserted an additional introducer at the side of the tip edge, caught the guidewire by a gooseneck snare, and hooked the residual balloon fragment. This also stabilized and increased the stiffness of the guidewire through the “pull-through technique.” Then, we reintroduced the gooseneck snare to catch the residual balloon. We then inserted a cobra-head catheter from the first introducer and pushed the residual balloon. We finally retrieved the ruptured balloon by pulling back the gooseneck snare and pushing using the cobra-head catheter simultaneously. Results: We could retrieve the ruptured balloons successfully using this technique and percutaneous transluminal angioplasty was continued in both cases. Conclusion: Our technique of retrieval may be suitable for cases of balloon rupture with a circumferential tear during percutaneous transluminal angioplasty. The technique enables less invasive retrieval and continuation of the percutaneous transluminal angioplasty thereafter.
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Papoyan, S. A., A. A. Shchegolev, D. G. Gromov, and K. S. Asaturyan. "Drug-coated balloon angioplasty in peripheral arterial disease." Russian Medical Inquiry 6, no. 4 (2022): 177–81. http://dx.doi.org/10.32364/2587-6821-2022-6-4-177-181.
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The prevalence of peripheral arterial disease requires the search for an optimal solution for preserving blood flow by using devices of various modifications. Drug-coated balloons are widely used in the surgical treatment of peripheral arterial disease. The article aims at the summarization of the study results on the efficacy and safety of the various drug-coated balloons, in particular, with paclitaxel, in the treatment of steno-occlusive lesions in the peripheral arterial disease. Comparing the study results is fraught with certain difficulties, given the differences in the study endpoints, the demographic characteristics of patients and the lesion patterns. Nevertheless, the study results of percutaneous transluminal angioplasty (PTA) with drug-eluting ballons on the femoropopliteal segment are superior to the results obtained using conventional PTA and other endovascular interventions in the same vascular bed. PTA with drug-eluting balloons has a Class 1 recommendation in accordance with the issued recommendations of the SCAI (Society for Cardiovascular Angiography and Interventions). However, conducting PTA with paclitaxel-eluting balloons requires further determination of the possibilities of its use. KEYWORDS: drug-coated balloons, paclitaxel, percutaneous transluminal angioplasty, angioplasty, atherosclerosis, peripheral arterial disease. FOR CITATION: Papoyan S.A., Shchegolev A.A., Gromov D.G., Asaturyan K.S. Drug-coated balloon angioplasty in peripheral arterial disease. Russian Medical Inquiry. 2022;6(4):177–181 (in Russ.). DOI: 10.32364/2587-6821-2022-6-4-177-181.
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Terry, Anna, Gregory Zipfel, Eric Milner, et al. "Safety and technical efficacy of over-the-wire balloons for the treatment of subarachnoid hemorrhage–induced cerebral vasospasm." Neurosurgical Focus 21, no. 3 (2006): 1–7. http://dx.doi.org/10.3171/foc.2006.21.3.14.
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Object Over the past decade, low-pressure, flow-directed balloons have been replaced by over-the-wire balloons in the treatment of vasospasm induced by subarachnoid hemorrhage (SAH). The authors assess the procedural safety and technical efficacy of these newer devices. Methods Seventy-five patients who underwent 85 balloon angioplasty procedures for the treatment of SAH-induced vasospasm were identified from a prospective quality-assurance database. Medical records and angiographic reports were reviewed for evidence of procedural complications and technical efficacy. No vessel rupture or perforation occurred, but thromboembolic complications were noted in four (4.7%) of the 85 procedures. Balloon angioplasty was frequently attempted and successfully accomplished in the distal internal carotid (100%), proximal middle cerebral (94%), vertebral (73%), and basilar (88%) arteries. Severe narrowing was present in 89 proximal anterior cerebral arteries. Angioplasty was attempted in 41 of these vessels and was successful in only 14 (34%). In 19 of the 27 unsuccessful attempts, the balloon could not be advanced over the wire due to severe vasospasm or unfavorable vessel angle. Follow-up angiography in a subset of patients demonstrated that severe recurrent vasospasm occurred in 15 (13%) of 116 vessels studied after angioplasty. Conclusions Over-the-wire balloons involve a low risk for vessel rupture. The anterior cerebral artery remains difficult to access and successfully treat with current devices. Further improvements in balloon design, such as smaller inflated diameters and better tracking, are necessary. Finally, thromboembolic complications remain an important concern, and severe vasospasm may recur after balloon angioplasty.
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Abdul Salim, Sohail, Hong Tran, Charat Thongprayoon, Tibor Fülöp, and Wisit Cheungpasitporn. "Comparison of drug-coated balloon angioplasty versus conventional angioplasty for arteriovenous fistula stenosis: Systematic review and meta-analysis." Journal of Vascular Access 21, no. 3 (2019): 357–65. http://dx.doi.org/10.1177/1129729819878612.
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Background: Arteriovenous fistula is the most preferred form of vascular access, but stenosis treated by balloon angioplasty is prone to restenosis. Multiple trials have been published with regard to the use of paclitaxel-coated balloon to prolong lesion patency compared to conventional balloon. Although paclitaxel-coated balloon has theoretical appeal, its use has not been widespread nationwide due to cost and lack of large-scale multicenter studies. We performed this meta-analysis to evaluate whether paclitaxel-coated balloon outperforms conventional balloon to prolong target lesion patency. Methods: PubMed/Medline, Clinical Trials.gov, EMBASE, Scopus, Web of Science, and Cochrane Central were searched from inception through April 2019 for studies that investigated the use of paclitaxel-coated balloon in arteriovenous fistula. Results: Ten studies were included in the final meta-analysis: six studies were randomized controlled trials and four studies were cohort studies. There were 911 participants with a mean age of 64.78 (±5.96) years, and 61.89% were male. Outcome of interest was target lesion primary patency, recorded at 1, 3, 6, 7, 12, and 24 months. Meta-analysis of randomized controlled trials shows that paclitaxel-coated balloons did not statistically improve target lesion primary patency compared to conventional balloons at months 1 (odds ratio = 1.54, p = 0.6373), 3 (odds ratio = 0.57, p = 0.0575), 6 (odds ratio = 0.65, p = 0.3644), 7 (odds ratio = 0.63, p = 0.0582), 12 (odds ratio = 0.64, p = 0.0612), and 24 (odds ratio = 0.43, p = 0.3452). Effect of paclitaxel-coated balloons was statistically significant for cohort studies at months 6 (odds ratio = 0.26, p = 0.0007), 12 (odds ratio = 0.21, p = 0.0001), and 24 (odds ratio = 0.23, p = 0.01). Conclusion: Paclitaxel-coated balloon showed no statistically significant improvement over conventional balloons in decreasing fistula stenosis in randomized controlled trial but were significant for cohort studies.
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Oktaviono, Yudi Her. "PCI IN PATIENT WITH HEAVY CALCIFIED LESION. MANAGEMENT AND BALLOON RUPTURE COMPLICATION." Folia Medica Indonesiana 51, no. 4 (2016): 257. http://dx.doi.org/10.20473/fmi.v51i4.2856.
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Balloon angioplasty in calcified coronary lesions may have a decreased success rate and an increased incidence of complications. This lesion remain a technical challenge in interventional cardiology despite novel approaches and devices. We describe a case with heavy calcified coronary lesion in LAD that was not only resistant to high-pressure inflation of conventional, non-compliant balloons and cutting balloon but the inflations also results in balloon rupture. Even, the first balloon became fracture and entrapment in LAD. The fractured balloon could be removed using second baloon inflation in LCX. The angioplasty balloon was successfully performed after rotational atherectomy by rotablator and succesfully continued by implantation stent DES.
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Bussière, Miguel, Stephen P. Lownie, Donald Lee, Irene Gulka, Andrew Leung, and David M. Pelz. "Hemodynamic instability during carotid artery stenting: the relative contribution of stent deployment versus balloon dilation." Journal of Neurosurgery 110, no. 5 (2009): 905–12. http://dx.doi.org/10.3171/2008.9.jns08509.
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Object Hemodynamic instability may complicate carotid angioplasty and stenting in up to 40% of patients. The authors have previously demonstrated that primary self-expanding stent placement alone can gradually dilate severely stenosed carotid arteries without the use of balloons. The authors hypothesized that eliminating the balloon would reduce carotid baroreceptor stimulation, thereby decreasing the incidence of hemodynamic instability. Methods Ninety-seven high surgical risk patients with symptomatic, severely stenosed carotid arteries were treated with the intention of using a self-expanding stent alone. Seventy-seven arteries (79%) were treated with stenting alone, and 20 required angioplasty (21%). Results Intraprocedural bradycardia (heart rate < 60 bpm) developed in 29 patients (38%) and hypotension (systolic blood pressure < 90 mm Hg) occurred in 1 patient (1%) treated with stenting alone. Fourteen patients (70%) who underwent angioplasty and stenting had bradycardia, and hypotension developed in 4 (20%). Atropine, glycopyrrolate, or vasopressors were required in 8% of patients who received stenting alone, compared to 30% of patients who underwent angioplasty. In the first 24 hours after treatment, hypotension or bradycardia developed in 25 patients (32%) who had undergone stent placement alone, and in 15 patients (75%) after stent placement and balloon angioplasty. There was no difference in the occurrence of intra- or postprocedural hypertension (systolic blood pressure > 160 mm Hg) between patients treated with stenting alone or stenting and balloons. Factors independently associated with hemodynamic depression included baseline heart rate and balloon use. Conclusions Hemodynamic instability during and after carotid artery stenting was observed more frequently when balloon angioplasty was required than when stent placement was performed without concurrent balloon angioplasty.
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Lugenbiel, Ira, Michaela Grebner, Qianxing Zhou, et al. "Treatment of femoropopliteal lesions with the AngioSculpt scoring balloon – results from the Heidelberg PANTHER registry." Vasa 47, no. 1 (2018): 49–55. http://dx.doi.org/10.1024/0301-1526/a000671.
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Abstract. Background: Treatment of calcified femoropopliteal lesions remains challenging, even in the era of drug-eluting balloon angioplasty. Lesion recoil and dissections after standard balloon angioplasty in calcific lesions often require subsequent stent implantation. Additionally, poor patency rates in calcified lesions despite the use of drug-eluting balloons may be due to the limited penetration depth of the antiproliferative drug in the presence of vascular calcium deposits. Therefore, preparation of calcified lesions with the AngioSculpt™ scoring balloon might be a valuable option either as a stand-alone treatment, followed by drug-eluting balloon angioplasty or prior to subsequent stent deployment. Patients and methods: In this retrospective, single centre registry, 124 calcified femoropopliteal lesions were treated in 101 subsequent patients. All patients were treated with scoring balloon angioplasty, either alone, in combination with drug-eluting balloons, or prior to stent deployment. The primary outcome was safety and technical success during the index procedure as well as patency at six and 12 months, as evaluated by duplex sonography. Results: Successful scoring was safely performed in all 124 lesions with the AngioSculpt™ balloon. Overall primary patency after 12 months was 81.2 %. Patency rates did not differ significantly between the three treatment strategies. Degree of calcification did not predict patency. Improved clinical outcomes (Rutherford-Becker class and ankle-brachial index) were also observed in the study cohort. Conclusions: Preparation with the AngioSculpt™ scoring balloon offers a safe and valuable treatment option for calcified femoropopliteal lesions.
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Chaivanit, Trakarn, Pechngam Chaivanit, Pakpume Bumrungrachapukdee, Pongtrip Unprasert, Krittanont Wattanavaekin, and Thoetphum Benyakorn. "Comparison of Primary Patency Rate between Drug- Coated Balloon and Plain Balloon Angioplasty in Hemodialysis Access." Siriraj Medical Journal 74, no. 6 (2022): 388–94. http://dx.doi.org/10.33192/smj.2022.47.
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Objective: Hemodialysis adequacy in end-stage renal disease patients plays a crucial role in their quality of life. Repeated stenosis at the anastomotic site of arteriovenous fistula and synthetic arteriovenous graft are a major cause of access failure resulting in hospitalization, catheter usage, and contributing substantially to increased health care costs. Although standard plain balloon angioplasty (PBA) is successful, the patency rate over time is often poor. Drug-coated balloons (DCB) delivering an anti-restenosis agent, Paclitaxel, may improve patency. In this study, we aimed to investigate whether there is an increase in primary patency rate in drug-coated balloon angioplasty compared to conventional plain balloon angioplasty.Materials and Methods: We performed a retrospective analysis of 55 patients with stenotic arteriovenous fistulas (AVF), and arteriovenous grafts (AVG) treated with DCB or PBA. Thirty-five patients were treated with drug-coated balloons, while twenty patients were treated with the standard plain balloon angioplasty. Follow up assessment was scheduled at three months, six months, and nine months. Our primary outcome was the primary patency rate, defined as the interval from the time of intervention until hemodialysis inadequacy.Results: There were 55 patients including twenty-one males and thirty-four females participated in the study. The average age of the 55 patients was 65.43 ± 12.89 years. Thirty (54.5%) patients were diabetes mellitus and 40 (72.7%) patients had hypertension. Seven patients (12.7%) had dyslipidemia. Eight patients (14.5%) had ischemic heart disease. And four patients (7.3%) had hyperparathyroidism. No significant differences in patency rate were found between gender, age group and patients’ underlying diseases. The proportion of primary patency rate comparing between the DCB and PBA treatment was 96.3% versus 73.9% at 6 months (P=0.017) and 92.6% versus 40% at 9 months (P<0.001). After multivariable analysis was performed (adjusted for sex, age, and underlying diseases), we found that stenosis was more likely to occur in patients who had undergone plain balloon angioplasty rather than drug-coated balloon angioplasty (HR 15.75; 95% CI 2.5%-99.1%, P=0.003).Conclusion: Drug-coated balloon angioplasty, when compared with plain balloon angioplasty, achieves a more desirable primary patency rate at 6 months and 9 months after the procedure.
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NGUYEN, THACH, PHAM MANH HUNG, NGUYEN QUANG TUAN, JAMES HERMILLER, JOHN S. DOUGLAS, and CINDY GRINES. "Balloon Angioplasty." Journal of Interventional Cardiology 14, no. 5 (2001): 563–69. http://dx.doi.org/10.1111/j.1540-8183.2001.tb00373.x.
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Rai, Alireza, and Mohammadreza Sobhiyeh. "Comparison of the efficacy of using paclitaxel-eluting balloon and plain balloon angioplasty for arteriovenous fistula in hemodialysis patients." Biomedical Research and Therapy 6, no. 5 (2019): 3151–55. http://dx.doi.org/10.15419/bmrat.v6i5.541.
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Introduction: Arteriovanous (AV) access failure is one of the main problems in patients with end stage renal disease (ESRD), who receive hemodialysis. Balloon angioplasty is a favorable method for managing vascular access failure. The purpose of this study was to compare the six-month efficacy of paclitaxel-eluting balloon and plain balloon angioplasty in failed AV access cases among hemodialysis patients.
 Methods: In this quasi-experimental study (http://en.irct.ir/trial/35333), 50 hemodialysis patients with failure of AV access (stenosis > 50%), who were candidates for angioplasty, were included. They were divided to receive either paclitaxel-eluting balloon (25 patients) or plain balloon (25 patients) angioplasty. Patients were followed up for six months with color Doppler ultrasonography and clinical examination for the hemodynamic success rate of angioplasty.
 Results: After six months, 19 patients (76%) in paclitaxel-eluting balloon angioplasty group achieved hemodynamic success, which was significantly higher than plain balloon angioplasty group (13 patients, 52%) (P = 0.012). Age, gender, diabetes mellitus, hypertension, and location of AVF (snuff box, forearm, and antecubital fossa) did not associate with hemodynamic success rate in any group.
 Conclusion: The use of angioplasty with paclitaxel-eluting balloon was superior to plain balloon angioplasty for failed AV access cases in hemodialysis patients. It is recommended to use paclitaxeleluting balloon angioplasty in patients with failure of AV access and requirement for balloon angioplasty.
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Mohammed, Shaymaa Jalal, and Aso Faeq Salih. "Immediate and Intermediate Outcomes of Balloon Angioplasty in Neonatal Type Coarctation of Aorta in Sulaimani Cardiac Center." Advanced Medical Journal 4, no. 2 (2018): 7–11. http://dx.doi.org/10.56056/amj.2018.52.
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Background and objectives: Coarctation of aorta is the fourth most prevalent heart disease in infants requiring catheterization and surgery during the first year of life. Unfortunately, the initial clinical manifestations in infants are non-specific and mainly consist of tachypnea, poor feeding, and failure to thrive which result in delays in the correct diagnosis and therapeutic interventions. The aim of the study was to assess the immediate and intermediate outcome of balloon angioplasty in neonatal-type coarctation of aorta. Methods: It is a case series study of 13 young infants with neonatal coarctation of aorta their ages were between 10 days to 18 months and were admitted to intensive care unit of pediatric teaching hospital and Shar Hospital neonatal care unit in Sulaimani. Balloon angioplasty was done for them in Sulaimani cardiac center between February 2014 to October 2017. Results: Balloon angioplasty was done for 13 young infants with good results in 10/13 cases without any complication. There were significant mean pressure gradient changes before and after the procedure (48 ± 18.57mmHg and 28.15 ±16.12mmHg, respectively). The complications of balloon angioplasty were divided into immediate complications which occurred within 24h post angioplastic procedure and included peripheral cyanosis1case (7.7%), small aneurysm formation 1 case(7.7%), and intermediate complications which occurred within 6 month of the angioplasty showed repeated dilatation of coarctation in 1 case (7.7%), while in 10 cases (76.9%) there were no any complications. Conclusions: Balloon angioplasty is a safe and effective treatment option in infants with coarctation of aorta; however, timely diagnosis and improvement in angioplasty techniques are necessary to improve the outcome.
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Popitiu, Mircea, Sorin Barac, Florin Borcan, Giacomo Clerici, and Andreea Rata. "Comparative Investigation on Polymer Drug-coating Balloons Used in Infrapopliteal Angioplasty Based on Angiosomes Concept." Materiale Plastice 59, no. 2 (2022): 183–93. http://dx.doi.org/10.37358/mp.22.2.5597.
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Atherosclerosis can affect the blood vessels in any region of the body and the stenosis (narrowing) can be located on an artery that vascularize important organs, such as the brain, abdominal organs or limbs. The endovascular surgery is a modern approach to vascular pathology through minimally invasive techniques (puncture, minimally vascular approach) and it represents an enrichment of the arsenal of surgical techniques and brings considerable improvements in post-operative and long-term outcomes The use of polymer drug-coating balloons is an attractive alternative because they can offer the promise of an improved patency compared to the simple balloons and a reduction in the need for stents. The aims of this study were to describe the polymer materials and to compare the medical endpoints obtained in angiosome-targeted infrapopliteal angioplasty using a simple balloon with two layers, based on polyethylene, and respectively a drug-coated balloon that contains a multiblock copolymer from polyethylene, poly(cylohexylethylene), polyisoprene and poly(1,3-butadiene) covered by Paclitaxel. The balloons were characterized by differential scanning calorimetry, stress-strain and puncture tests in order to describe their physical and mechanical characteristics. On the other hand, 51 patients with critical limb ischemia were treated with different balloon angioplasty and they were monitored for 12 months after the intervention; the following parameters have been evaluated: diabetes, hypertension, renal insufficiency, hemodialysis, stroke, dyslipidemia, heart disease, heart failure, body mass index, number of angiosomes, creatinine, and wound healing, leg salvage and amputation-free survival at 1, 2, 3, 6, 9, 12 months. Significant associations were found in the case of anterior-tibial-artery and posterior-tibial-artery angioplasy and the age, hypertension and renal insufficiency. On the other hand, the results indicate that the drug deposition on the surface of the balloons lead to improved values for the observed medical endpoints. In conclusion, this study reveals that angiosome-based infrapopliteal angioplasty with drug-coated balloons can be associated with better wound healing and leg salvage.
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Ludyga, T., M. Kazibudzki, M. Simka, et al. "Endovascular treatment for chronic cerebrospinal venous insufficiency: is the procedure safe?" Phlebology: The Journal of Venous Disease 25, no. 6 (2010): 286–95. http://dx.doi.org/10.1258/phleb.2010.010053.
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Objectives The aim of this report is to assess the safety of endovascular treatment for chronic cerebrospinal venous insufficiency (CCSVI). Although balloon angioplasty and stenting seem to be safe procedures, there are currently no data on the treatment of a large group of patients with this vascular pathology. Methods A total of 564 endovascular procedures (balloon angioplasty or, if this procedure failed, stenting) were performed during 344 interventions in 331 CCSVI patients with associated multiple sclerosis. Results Balloon angioplasty alone was performed in 192 cases (55.8%), whereas the stenting of at least one vein was required in the remaining 152 cases (44.2%). There were no major complications (severe bleeding, venous thrombosis, stent migration or injury to the nerves) related to the procedure, except for thrombotic occlusion of the stent in two cases (1.2% of stenting procedures) and surgical opening of femoral vein to remove angioplastic balloon in one case (0.3% of procedures). Minor complications included occasional technical problems (2.4% of procedures): difficulty removing the angioplastic balloon or problems with proper placement of stent, and other medical events (2.1% of procedures): local bleeding from the groin, minor gastrointestinal bleeding or cardiac arrhythmia. Conclusions The procedures appeared to be safe and well tolerated by the patients, regardless of the actual impact of the endovascular treatments for venous pathology on the clinical course of multiple sclerosis, which warrants long-term follow-up.
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Björkman, P., E. M. Weselius, T. Kokkonen, V. Rauta, A. Albäck, and M. Venermo. "Drug-Coated Versus Plain Balloon Angioplasty In Arteriovenous Fistulas: A Randomized, Controlled Study With 1-Year Follow-Up (The Drecorest Ii-Study)." Scandinavian Journal of Surgery 108, no. 1 (2018): 61–66. http://dx.doi.org/10.1177/1457496918798206.
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Background and Aims: Stenosis due to intimal hyperplasia and restenosis after initially successful percutaneous angioplasty are common reasons for failing arteriovenous fistulas. The aim of this study was to evaluate the effect of drug-coated balloons in the treatment of arteriovenous fistula stenosis. Design: Single-center, parallel group, randomized controlled trial. Block randomized by sealed envelope 1:1. Materials and Methods: A total of 39 patients with primary or recurrent stenosis in a failing native arteriovenous fistulas were randomized to drug-coated balloon (n = 19) or standard balloon angioplasty (n = 20). Follow-up was 1 year. Primary outcome measure was target lesion revascularization. Results: In all, 36 stenoses were analyzed; three patients were excluded due to technical failure after randomization. A total of 88.9% (16/18) in the drug-coated balloon group was revascularized or occluded within 1 year, compared to 22.2% (4/18) of the stenoses in the balloon angioplasty group (relative risk for drug-coated balloon 7.09). Mean time-to- target lesion revascularization was 110 and 193 days after the drug-coated balloon and balloon angioplasty, respectively (p = 0.06). Conclusions: With 1-year follow-up, the target lesion revascularization-free survival after drug-coated balloon-treatment was clearly worse. The reason for this remains unknown, but it may be due to differences in the biological response to paclitaxel in the venous arteriovenous fistula-wall compared to its antiproliferative effect in the arterial wall after drug-coated balloon treatment of atherosclerotic occlusive lesions. Trial registration: ClinicalTrials.gov NCT03036241
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Trerotola, Scott O., Jeffrey Lawson, Prabir Roy-Chaudhury, and Theodore F. Saad. "Drug Coated Balloon Angioplasty in Failing AV Fistulas." Clinical Journal of the American Society of Nephrology 13, no. 8 (2018): 1215–24. http://dx.doi.org/10.2215/cjn.14231217.
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BackgroundRestenosis remains a problem in hemodialysis access interventions. Paclitaxel-coated balloons have shown promise in reducing access-related restenosis in small trials. The primary hypotheses for our multicenter trial were superior effectiveness at 180 days and noninferior safety at 30 days of a drug-coated balloon compared with conventional angioplasty for treatment of dysfunctional arteriovenous fistulas.Design, setting, participants, & measurementsThis randomized trial enrolled 285 patients with dysfunctional arteriovenous fistulas at 23 centers. Grafts, central venous stenoses, thrombosed fistulas, and immature fistulas were excluded. All patients received angioplasty of the lesion responsible for access dysfunction. After successful angioplasty (≤30% residual stenosis), lesions were treated with either a paclitaxel-coated balloon or an uncoated control balloon of similar design to the drug-coated balloon. Access function during follow-up was determined per centers’ usual protocols; reintervention was clinically driven. The primary efficacy outcome assessment was done at 6 months, and the safety assessment was done within 30 days of the procedure. Prespecified secondary end points included assessment of postintervention target lesion primary patency and access circuit primary patency at 6 months.ResultsThe 180-day end point was not met with target lesion primary patency (71%±4% for the drug-coated balloon and 63%±4% for control; P=0.06), representing a difference of 8%±6% (95% confidence interval, −3% to 20%). Access circuit primary patency did not differ between groups. Interventions to maintain target lesion patency were fewer for the drug-coated balloon at 6 months (0.31 versus 0.44 per patient; P=0.03). The primary safety noninferiority end point was met and did not differ between groups (P=0.002).ConclusionsPaclitaxel-coated balloon–assisted angioplasty did not meet the primary effectiveness end point at 180 days compared with conventional angioplasty. Both arms showed equivalent safety (ClinicalTrials.gov number NCT02440022).
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Weber, György, and Tibor Kiss. "Intraoperative balloon angioplasty." European Journal of Vascular Surgery 3, no. 2 (1989): 153–57. http://dx.doi.org/10.1016/s0950-821x(89)80011-8.
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McCollum, P. T., J. W. Shaw, and P. Hickman. "Intraoperative balloon angioplasty." British Journal of Surgery 79, no. 11 (1992): 1125–26. http://dx.doi.org/10.1002/bjs.1800791104.
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Murphy, G. J., and J. N. Johnson. "Intraoperative balloon angioplasty." British Journal of Surgery 80, no. 3 (1993): 401. http://dx.doi.org/10.1002/bjs.1800800354.
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Favereau, X., T. Corcos, M. Zimarino, and G. Souffrant. "Tandem balloon angioplasty." Catheterization and Cardiovascular Diagnosis 29, no. 1 (1993): 74–75. http://dx.doi.org/10.1002/ccd.1810290116.
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Chaudhry, Nauman S., Jennifer L. Orning, Sophia F. Shakur, et al. "Safety and efficacy of balloon angioplasty of the anterior cerebral artery for vasospasm treatment after subarachnoid hemorrhage." Interventional Neuroradiology 23, no. 4 (2017): 372–77. http://dx.doi.org/10.1177/1591019917699980.
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Balloon angioplasty is often performed for symptomatic vasospasm following aneurysmal subarachnoid hemorrhage. Angioplasty of the anterior cerebral artery (ACA), however, is perceived to be a challenging endeavor and not routinely performed due to technical and safety concerns. Here, we evaluate the safety and efficacy of balloon angioplasty of the anterior cerebral artery for vasospasm treatment. Patients with vasospasm following subarachnoid hemorrhage who underwent balloon angioplasty at our institution between 2011 and 2016 were retrospectively reviewed. All ACA angioplasty segments were analyzed for pre- and post-angioplasty radiographic measurements. The degree of vasospasm was categorized as mild (<25%), moderate (25–50%), or severe (>50%), and relative change in caliber was measured following treatment. Clinical outcomes following treatment were also assessed. Among 17 patients, 82 total vessel segments and 35 ACA segments were treated with balloon angioplasty. Following angioplasty, 94% of segments had increased caliber. Neurological improvement was noted in 75% of awake patients. There were no intra-procedural complications, but two patients developed ACA territory infarction, despite angioplasty treatment. We demonstrate that balloon angioplasty of the ACA for vasospasm treatment is safe and effective. Thus, ACA angioplasty should be considered to treat vasospasm in symptomatic patients recalcitrant to vasodilation infusion therapy.
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Gross, Bradley A., Daniel A. Tonetti, Gregory M. Weiner, et al. "Septoplasty: Scepter Balloon Angioplasty for Vasospasm after Aneurysmal Subarachnoid Hemorrhage." Interventional Neurology 6, no. 3-4 (2017): 229–35. http://dx.doi.org/10.1159/000477467.
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Introduction: Balloon angioplasty can be a requisite approach for the treatment of symptomatic and/or severe vasospasm. Dual-lumen microcatheter balloons have multiple potential advantages for this indication including accommodating a 0.014-inch wire and the potential to deliver superselective vasodilators directly via the microcatheter prior to angioplasty. Methods: The authors reviewed a 3-year institutional experience with the Scepter XC balloon (Microvention, Tustin, CA, USA) in the treatment of postaneurysmal subarachnoid hemorrhage vasospasm, focusing on treatment methods, angiographic, and clinical results. Results: Sixty-four vessels were treated in 18 patients. Fifteen cases were performed under intravenous (i.v.) conscious sedation (83%). The mean pretreatment stenosis was 59% (range 40-80), and the mean post-treatment stenosis was 12% (range 0-40). Five vessels in 3 patients were subsequently retreated via angioplasty for recurrent vasospasm (8%). There were no complications related to the passage of the balloon microcatheter or inflation of the balloon such as dissection or vessel rupture. Of 14 patients with delayed cerebral ischemia, 7 had complete symptomatic resolution after treatment, and 3 had significant symptomatic improvement. Four patients did not improve after treatment though 3 already had confirmed infarcts on imaging prior to angiography. Conclusion: The Scepter XC is a safe and effective balloon microcatheter for angioplasty of cerebral vasospasm after subarachnoid hemorrhage, allowing for superselective delivery of a vasodilator. Its ease of deliverability and visibility often allows for the performance of the procedure under i.v. conscious sedation.
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Pang, Shuyue, Tianying Chang, Mingxin Chang, et al. "Efficacy of cutting balloon angioplasty versus high-pressure balloon angioplasty for the treatment of arteriovenous fistula stenoses in patients undergoing hemodialysis: Systematic review and meta-analysis." PLOS ONE 19, no. 1 (2024): e0296191. http://dx.doi.org/10.1371/journal.pone.0296191.
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This systematic review and meta-analysis aimed to assess and compare the therapeutic outcomes of cutting balloon angioplasty and high-pressure balloon angioplasty for arteriovenous fistula stenosis in hemodialysis patients. All studies indexed in PubMed, Embase, and Cochrane Library Web of Science were retrieved. The retrieval deadline was July 15, 2023. Risk of bias 2.0 was used to evaluate the quality of the included studies. Revman 5.4 software was used for data analysis. This review included three studies and 180 patients, with 90 patients in the cutting balloon angioplasty group and 90 patients in the high-pressure balloon angioplasty group. The results of the meta-analysis suggested that compared with high-pressure balloon angioplasty, cutting balloon angioplasty can improve primary lesion patency rates of internal arteriovenous fistulas at 6 months (relative risk, 1.45; 95% confidence interval, 1.08–1.96; P = 0.01). However, there were no significant differences between the technical success rate (relative risk, 0.99; 95% confidence interval, 0.93–1.05; P = 0.72) and clinical success rate (relative risk, 1.01; 95% confidence interval, 0.95–1.07; P = 0.73). Therefore, cutting balloon angioplasty is likely to increase primary lesion patency rates at 6 months. However, more high-quality, large-sample, multicenter, randomized controlled trials are needed for further validation due to the limited number of included studies.
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Fransson, Torbjörn, Anders Gottsäter, Mohammad Abdulrasak, Martin Malina, and Timothy Resch. "Drug-eluting balloon (DEB) versus plain old balloon angioplasty (POBA) in the treatment of failing dialysis access: A prospective randomized trial." Journal of International Medical Research 50, no. 3 (2022): 030006052210816. http://dx.doi.org/10.1177/03000605221081662.
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Objective To compare the efficacy of angioplasty using drug-eluting balloons (DEB) compared with plain old balloon angioplasty (POBA) to reduce the rate of restenosis. Methods This prospective, single-centre, single-blinded, 1:1 randomized, clinical trial enrolled patients that had primary or restenotic lesions in native upper extremity arteriovenous (AV) fistulas or at the graft-venous anastomosis. Patients were randomized to angioplasty with a POBA or a DEB. The primary effectiveness endpoints were freedom from target lesion revascularization (TLR) and functional status of access circuit at 12 months. Results A total of 42 (28 male, 14 female; age range, 42–83 years) patients were enrolled. Patients were followed for 12 months. No significant differences were detected between the POBA and DEB groups regarding total number of TLR procedures (31 versus 36, respectively), freedom from TLR (3 versus 4, respectively) and functional status of the access circuit at 12 months (14 of 20 patients [70%] versus 17 of 22 patients [77%], respectively). Conclusion This clinical trial did not demonstrate any significant differences between DEB angioplasty and standard balloon angioplasty when treating dysfunctional haemodialysis access.
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Angelini, Paolo. "Balloon catheter coronary angioplasty: Balloon rupture." Catheterization and Cardiovascular Diagnosis 20, no. 2 (1990): 150–51. http://dx.doi.org/10.1002/ccd.1810200219.
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Khan, Asad, Muhammad Shahab Uddin Khalil, Abdul Latif, Muzdalfa Parvez, and Zarmina Ikram. "Efficacy of Coronary Stenting Versus Ballon Angioplasty in Small Coronary Arteries." Pakistan Journal of Medical and Health Sciences 16, no. 10 (2022): 911–13. http://dx.doi.org/10.53350/pjmhs221610911.
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Background and aim: The most common approach of percutaneous myocardial revascularization is stent placement. In de novo focal lesions found in big native arteries, balloon angioplasty had lower efficacy than coronary stenting. However, the usefulness of stenting in small arteries remains debatable. The purpose study aimed to compare the efficacy of coronary stenting vs. balloon angioplasty in small coronary arteries. Patients and Method: This comparative study was carried out on 132 patients with lesion in small coronary arteries (reference diameter <3mm) in the department of Interventional Cardiology, MTI- Hayat Abad Medical Complex, Peshawar from 16th January 2021 to 15th July 2022. Patients were arbitrarily assigned to stent implantation and standard balloon angioplasty. Study protocol was approved by research and ethical committee. Each individual provided written informed consent. The rates of clinical event were evaluated within 1 year. Descriptive statistics was carried out in SPSS version 26. Results: Of the total patients, there were 80 (60.6%) male and 52 (39.4%) were females. Both groups were assigned 66 patients and had similar baseline characteristics and angiography data. Based on treatment analysis, the major adverse cardiac events (MACEs) and angiographic success rate were similar: 5.2% and 96.8% in coronary stenting versus 5.9% and 92.4% in balloon angioplasty group respectively. About 4.2% patients underwent abrupt closure changes within 30 days. Stenting convened the substantially larger lumen (1.52 mm vs. 1.32 mm, p<0.001) at 6 months and larger post-procedural lumen diameter (2.31 vs. 1.82 mm, p<0.001) as compared to balloon angioplasty. The incidence of restenosis was found 36% and 56% in coronary stenting and balloon angioplasty respectively. The survival rate (event-free) was achieved in 79% and 69% (p=0.021) in coronary stenting and angioplasty respectively. Conclusion: The present study found that optimum balloon angioplasty with preliminary stenting may be a viable therapeutic option for small coronary arteries lesions. Restenosis was found to be 36% and 56% in coronary stenting and balloon angioplasty, respectively. Keywords: Restenosis, Small coronary arteries, Balloon angioplasty, Coronary stenting
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Atalay, Atakan, Aysenur Pac, Tugba Avci, et al. "Histopathological evaluation of aortic coarctation after conventional balloon angioplasty in neonates." Cardiology in the Young 28, no. 5 (2018): 683–87. http://dx.doi.org/10.1017/s1047951117002967.
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AbstractBackgroundOptimal management strategy for native aortic coarctation in neonates and young infants is still a matter of debate. The surgical procedure, histopathologic research, and clinical outcome in 15 neonates who underwent surgery after successful balloon angioplasty is the basis of this study.MethodBetween 01 October, 2014 and 01 August, 2017, we enrolled 15 patients with native aortic coarctation for this study. These patients had complications regarding recoarctation, following balloon angioplasty intervention at our institute and other centres. Surgically extracted parts were examined histopathologically and patient’s data were collected retrospectively.ResultThe reasons for recurrence of recoarctation after balloon angioplasty are as follows: patients with higher preoperative echocardiographic gradients had recoarctation earlier, neointimal proliferation, aortic intimal fibrosis at the region of ductal insertion, and ductal residual tissue debris after balloon angioplasty. No repeat intervention was required in the 15 patients who underwent surgery followed by balloon angioplasty. Early mortality was seen in one patient after surgery. Postoperative complication in the surgical group occurred in the form of chylothorax in one patient.ConclusionIn centres in which the neonatal ICU is inexperienced, balloon angioplasty is particularly recommended. In developing neonatal clinics, balloon angioplasty, when performed on patients at their earliest possible age, delays actual corrective operation to a later date, which in turn provides less risky surgical outcomes in infants who are gaining weight, growing, and do not have any haemodynamic complaints.
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Elliott, J. Paul, David W. Newell, Derek J. Lam, et al. "Comparison of balloon angioplasty and papaverine infusion for the treatment of vasospasm following aneurysmal subarachnoid hemorrhage." Neurosurgical Focus 3, no. 4 (1997): E10. http://dx.doi.org/10.3171/foc.1997.3.4.11.
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The authors used daily transcranial Doppler (TCD) evaluation to test the hypothesis that balloon angioplasty is superior to papaverine infusion for the treatment of proximal anterior circulation arterial vasospasm following subarachnoid hemorrhage (SAH). Between 1989 and 1995, 125 vasospastic distal internal carotid artery or proximal middle cerebral artery vessel segments were treated in 52 patients. Blood flow velocities of the involved vessels were assessed using TCD monitoring in relation to the day of treatment with balloon angioplasty or papaverine infusion. Balloon angioplasty and papavarine infusion cohorts were compared based on mean pretreatment velocity and mean posttreatment velocity at 24 and 48 hours using the one-tailed, paired-samples t-test. Balloon angioplasty alone was performed in 101 vessel segments (81%) in 39 patients (75%), whereas papaverine infusion alone was used in 24 vessel segments (19%) in 13 patients (25%). Although repeated treatment following balloon angioplasty was needed in only one vessel segment, repeated treatment following papaverine infusion was required in 10 vessel segments (42%) in six patients because of recurrent vasospasm (p < 0.001). Seven vessel segments (29%) with recurrent spasm following papaverine infusion were treated with balloon angioplasty. Although vessel segments treated with papaverine demonstrated a 20% mean decrease in blood flow velocity (p < 0.009) on posttreatment Day 1, velocities were not significantly lower than pretreatment levels by posttreatment Day 2 (p = 0.133). Balloon angioplasty resulted in a 45% mean decrease in velocity to a normal level following treatment (p < 0.001), which was sustained. The authors conclude that balloon angioplasty is superior to papaverine infusion for the permanent treatment of proximal anterior circulation vasospasm following aneurysmal SAH.
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Elliott, J. Paul, David W. Newell, Derek J. Lam, et al. "Comparison of balloon angioplasty and papaverine infusion for the treatment of vasospasm following aneurysmal subarachnoid hemorrhage." Journal of Neurosurgery 88, no. 2 (1998): 277–84. http://dx.doi.org/10.3171/jns.1998.88.2.0277.
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Object. The purpose of this study was to test the hypothesis that balloon angioplasty is superior to papaverine infusion for the treatment of proximal anterior circulation arterial vasospasm following subarachnoid hemorrhage (SAH). Between 1989 and 1995, 125 vasospastic distal internal carotid artery or proximal middle cerebral artery vessel segments were treated in 52 patients. Methods. Blood flow velocities of the involved vessels were assessed by using transcranial Doppler (TCD) monitoring in relation to the day of treatment with balloon angioplasty or papaverine infusion. Balloon angioplasty and papaverine infusion cohorts were compared based on mean pre- and posttreatment velocity at 24 and 48 hours using the one-tailed, paired-samples t-test. Balloon angioplasty alone was performed in 101 vessel segments (81%) in 39 patients (75%), whereas papaverine infusion alone was used in 24 vessel segments (19%) in 13 patients (25%). Although repeated treatment after balloon angioplasty was needed in only one vessel segment, repeated treatment following papaverine infusion was required in 10 vessel segments (42%) in six patients because of recurrent vasospasm (p < 0.001). Seven vessel segments (29%) with recurrent spasm following papaverine infusion were treated with balloon angioplasty. Although vessel segments treated with papaverine demonstrated a 20% mean decrease in blood flow velocity (p < 0.009) on posttreatment Day 1, velocities were not significantly lower than pretreatment levels by posttreatment Day 2 (p = 0.133). Balloon angioplasty resulted in a 45% mean decrease in velocity to a normal level following treatment (p < 0.001), a decrease that was sustained. Conclusions. Balloon angioplasty is superior to papaverine infusion for the permanent treatment of proximal anterior circulation vasospasm following aneurysmal SAH.
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Jenkins, Ronald D., I. Nigel Sinclair, Bradley M. Leonard, Tamas Sandor, Frederick J. Schoen, and J. Richard Spears. "Laser balloon angioplasty versus balloon angioplasty in normal rabbit iliac arteries." Lasers in Surgery and Medicine 9, no. 3 (1989): 237–47. http://dx.doi.org/10.1002/lsm.1900090306.
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Wiedenroth, MD, Christoph B., Andreas J. Rieth, MD, Steffen Kriechbaum, MD, et al. "Exercise right heart catheterization before and after balloon pulmonary angioplasty in inoperable patients with chronic thromboembolic pulmonary hypertension." Pulmonary Circulation 10, no. 3 (2020): 204589402091788. http://dx.doi.org/10.1177/2045894020917884.
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Background * These authors contributed equally as last authors. Balloon pulmonary angioplasty is an evolving, interventional treatment option for inoperable patients with chronic thromboembolic pulmonary hypertension (CTEPH). Pulmonary hypertension at rest as well as exercise capacity is considered to be relevant outcome parameters. The aim of the present study was to determine whether measurement of pulmonary hemodynamics during exercise before and six months after balloon pulmonary angioplasty have an added value. Methods From March 2014 to July 2018, 172 consecutive patients underwent balloon pulmonary angioplasty. Of these, 64 consecutive patients with inoperable CTEPH underwent a comprehensive diagnostic workup that included right heart catheterization at rest and during exercise before balloon pulmonary angioplasty treatments and six months after the last intervention. Results Improvements in pulmonary hemodynamics at rest and during exercise, in quality of life, and in exercise capacity were observed six months after balloon pulmonary angioplasty: WHO functional class improved in 78% of patients. The mean pulmonary arterial pressure (mPAP) at rest was reduced from 41 ± 9 to 31 ± 9 mmHg (p < 0.0001). The mPAP/cardiac output slope decreased after balloon pulmonary angioplasty (11.2 ± 25.6 WU to 7.7 ± 4.1 WU; p < 0.0001), and correlated with N-terminal fragment of pro-brain natriuretic peptide (p = 0.035) and 6-minute walking distance (p = 0.01). Conclusions Exercise right heart catheterization provides valuable information on the changes of pulmonary hemodynamics after balloon pulmonary angioplasty in inoperable CTEPH patients that are not obtainable by measuring resting hemodynamics.
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Björkman, P., E. Peltola, A. Albäck, and M. Venermo. "Peripheral Vascular Restenosis: A Retrospective Study on the Use of Drug-Eluting Balloons in Native Arteries, Vein Grafts and Dialysis Accesses." Scandinavian Journal of Surgery 106, no. 2 (2016): 158–64. http://dx.doi.org/10.1177/1457496916654098.
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Background and Aims: The objective of this study is to analyze outcomes of the first experiences with drug-eluting balloons in native arteries, vein grafts, and vascular accesses. The study is also a pilot for our future prospective, randomized, and controlled studies regarding the use of drug-eluting balloons in the treatment of the stenosis in bypass vein graft and dialysis access. Materials and Methods: A total of 93 consecutive patients were retrospectively analyzed and in the end 81 were included in the study. Inclusion criteria included at least one previous percutaneous angioplasty to the same lesion. Patients were divided into three groups according to the anatomical site of the lesion: native lower limb artery, vein bypass graft, or vascular access. Time from the previous percutaneous angioplasty to the drug-eluting balloon was compared to the time from the drug-eluting balloon to endpoint in the same patient. Endpoints included any new revascularization of the target lesion, major amputation, or new vascular access. Results: The median time from the drug-eluting balloon to endpoint was significantly longer than the median time from the preceding percutaneous angioplasty to drug-eluting balloon in all three groups. This difference was clearest in native arteries and vein grafts, whereas the difference was smaller from the beginning and disappeared over time in the vascular access group. No significant differences were seen between the groups with regard to smoking, antiplatelet regime, diabetes, Rutherford classification, or sex. Conclusion: Although the setup of this study has several limitations, the results suggest that there could be benefit from drug-eluting balloons in peripheral lesions. Very little data have been published on the use of drug-eluting balloons in vein grafts and vascular accesses, and randomized and controlled prospective studies are needed to further investigate this field.
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Iskhakov, M. M., R. R. Sayfullin, I. R. Yagafarov, et al. "Primary percutaneous coronary interventions in patients with ST-segment elevation myocardial infarction complicated by «no-reflow» phenomenon." Kazan medical journal 96, no. 3 (2015): 325–29. http://dx.doi.org/10.17750/kmj2015-325.
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Aim. To study the association of «no-reflow» phenomenon incidence and the method of primary percutaneous coronary intervention for ST-segment elevation acute myocardial infarction, and to determine the optimal tactics for primary coronary intervention.Methods. A retrospective analysis of 1339 cases of primary percutaneous coronary intervention for ST-segment elevation myocardial infarction performed in the period from January 2008 to June 2013 was executed. Depending on surgery method, all the patients were allocated to four groups: first group - direct stenting (n=483); second group - thromboaspiration before stenting (n=142); third group - balloon angioplasty and stenting using a small-diameter balloon ≤2.0 mm (n=491); fourth group - balloon angioplasty and stenting using a small-diameter balloon and subsequent use of medium and large-diameter balloons ≥2.0 mm (n=223).Results. «No-reflow» phenomenon was observed in 164 (12.2%) of cases, incliding 34 (7.0%) cases in the first group, 12 (8.4%) cases in the second group, 53 (10.8%) cases in the third group, and with the majority of cases seen in the fourth group - 65 (29.1%). At primary percutaneous coronary intervention, the following incidence of «no-reflow» phenomenon was observed depending on the infarct-related artery: left anterior descending artery - 85 cases (51.82% of the total number), right coronary artery - 51 (31.09%) cases, circumflex artery - 28 (17.07%) cases, and diagonal branch - 1 (0.6%) case.Conclusion. In primary percutaneous coronary intervention with direct stenting and thromboaspiration before stenting, the incidence of «no-reflow» phenomenon is significantly lower. Patients who undergo primary percutaneous coronary intervention preceded by repeated balloon angioplasty using medium and large-diameter balloons are at higher risk for «no-reflow» phenomenon.
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Linnemeier, T. J., and D. C. Cumberland. "PERCUTANEOUS LASER CORONARY ANGIOPLASTY WITHOUT BALLOON ANGIOPLASTY." Lancet 333, no. 8630 (1989): 154–55. http://dx.doi.org/10.1016/s0140-6736(89)91164-1.
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Ionescu, Costin N., Sophia E. Altin, and Carlos Mena-Hurtado. "Antiplatelet therapy for tibial balloon angioplasty: A clinical perspective." SAGE Open Medicine 7 (January 2019): 205031211985457. http://dx.doi.org/10.1177/2050312119854579.
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Percutaneous transluminal tibial balloon angioplasty has an important role in the therapeutic approach of critical limb ischaemia. Despite a growing number of patients with critical limb ischaemia, there are no trials to guide the pharmacologic approach post intervention. Guidelines pertaining to the antiplatelet therapy post percutaneous transluminal tibial balloon angioplasty have not been developed. In addition, critical limb ischaemia patients have multiple comorbidities and a higher risk of bleeding. To examine the shortest duration of antiplatelet therapy post percutaneous transluminal tibial balloon angioplasty, we reviewed the preclinical data used to develop the standards for the current angioplasty technique.
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Kocaaslan, Cemal, Ahmet Oztekin, Mehmet Senel Bademci, Emine Seyma Denli Yalvac, Nurgul Bulut, and Ebuzer Aydin. "A retrospective comparison analysis of results of drug-coated balloon versus plain balloon angioplasty in treatment of juxta-anastomotic de novo stenosis of radiocephalic arteriovenous fistulas." Journal of Vascular Access 21, no. 5 (2019): 596–601. http://dx.doi.org/10.1177/1129729819893205.
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Background: Juxta-anastomotic stenosis is a common issue of arteriovenous fistulas. We aimed to evaluate the results of percutaneous transluminal angioplasty with drug-coated balloon versus plain balloon for the treatment of juxta-anastomotic stenoses of mature but failing distal radiocephalic arteriovenous fistulas. Methods: A total of 80 patients with a juxta-anastomotic stenosis of distal radiocephalic arteriovenous fistula in our clinic between January 2016 and September 2017 were retrospectively analyzed. Patients were divided into two groups according to the type of treatment as drug-coated balloon – percutaneous transluminal angioplasty (n = 44) and plain balloon – percutaneous transluminal angioplasty (n = 43). Intra- and post-procedural data were recorded. Target lesion primary patency rate was evaluated at 6 and 12 months. Of all patients, 48 were females and 39 were males with a mean age of 56.3 ± 10.4 (range, 24–75) years. Both groups had mature fistulas, and the mean age of fistula was 11.3 ± 9.1 months in the drug-coated balloon – percutaneous transluminal angioplasty group and 10.3 ± 8.8 months in the plain balloon – percutaneous transluminal angioplasty group (p = 0.24). Results: There was no significant difference in the target lesion stenosis rate and the median lesion length between the groups. Technical and clinical success were achieved in both groups. Target lesion primary patency was similar at 6 months between the two groups (93.1% vs 81.3%, respectively; p = 0.14) but significantly higher for the drug-coated balloon – percutaneous transluminal angioplasty group at 12 months (81.8% vs 51.1%, respectively; p = 0.01). Conclusion: Our study results suggest that the use of drug-coated balloon combined with percutaneous transluminal angioplasty is an effective treatment for juxta-anastomotic stenoses of mature but failing distal radiocephalic arteriovenous fistulas with significantly improved target lesion primary patency rates and reduced need for juxta-anastomotic reinterventions.
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Fleenor, Bradley S., and Douglas K. Bowles. "Negligible contribution of coronary adventitial fibroblasts to neointimal formation following balloon angioplasty in swine." American Journal of Physiology-Heart and Circulatory Physiology 296, no. 5 (2009): H1532—H1539. http://dx.doi.org/10.1152/ajpheart.00566.2008.
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Adventitial fibroblasts have previously been proposed to be a major constituent of the neointima following coronary balloon angioplasty. The present study utilized the bromodeoxyuridine (BrdU) pulse-chase technique to track adventitial fibroblast migration early after balloon injury in swine. BrdU (30 mg/kg), a marker of proliferating cells, was given intravenously 1 or 2 days after balloon angioplasty. For each time point, one animal was euthanized 24 h after injection to identify the location of the proliferating cells, while a second animal was euthanized 25 days after angioplasty to determine whether the proliferating cells migrated to form the neointima. Our results demonstrate that BrdU-positive cells were located primarily in the adventitia with all three time points 24 h after balloon angioplasty. Furthermore, when BrdU was injected on day 1 or 2 only 0.65 ± 0.17% and 1.7 ± 0.64%, respectively, of neointimal cells were BrdU positive on day 25. In conclusion, these results demonstrate a negligible contribution of coronary adventitial fibroblasts to neointima formation following coronary balloon angioplasty, supporting the concept that the neointima is primarily of smooth muscle cell origin.
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Tozzi, Matteo, Marco Franchin, Daniele Savio, et al. "Drug-coated balloon angioplasty in failing haemodialysis arteriovenous shunts: 12-month outcomes in 200 patients from the Aperto Italian registry." Journal of Vascular Access 20, no. 6 (2019): 733–39. http://dx.doi.org/10.1177/1129729819848609.
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Background: We evaluated the safety and technical and clinical outcomes of angioplasty with a drug-coated balloon for the management of venous stenosis in arteriovenous grafts and arteriovenous fistulas in patients undergoing haemodialysis. Methods: Data were obtained from an ongoing prospective, non-randomised registry conducted at three Italian centres. Patients were treated with a drug-coated balloon according to standard procedures in each participating centre. Evaluation was by colour Doppler imaging every 3 months. The primary end-point was primary assisted patency. The secondary end-point was the rate of assisted patency of the vascular access. Results: A total of 311 angioplasty procedures in 200 patients, (60.4% male), were analysed. The procedural success rate was 100%. A total of 192 treatments of restenosis were necessary in 81 patients during average 21 ± 8 months follow-up. Kaplan–Meier estimates indicated that 88.0%, 64.2% and 40.6% of treated lesions were free from restenosis at 6, 12 and 24 months, respectively. Including multiple angioplasty, circuit patency rates were 99.2%, 92.5% and 84.8% at 6, 12 and 24 months, respectively. Primary patency rates were highest in shunts treated de novo with drug-coated balloons. Risk of restenosis was associated with circuit age (p = 0.017), history of treatment with conventional angioplasty (p < 0.001) and the kind of balloon used during pre-dilation (p = 0.001). Conclusion: The results suggest that favourable long-term patency rates can be achieved with the drug-coated balloon in a varied population of patients with failing haemodialysis arteriovenous shunts treated under conditions of actual care.
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O'Boyle, Matthew. "Ultrasonic angioplasty balloon catheter." Journal of the Acoustical Society of America 102, no. 4 (1997): 1928. http://dx.doi.org/10.1121/1.421022.
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O'Boyle, Matthew. "Ultrasonic angioplasty balloon catheter." Journal of the Acoustical Society of America 102, no. 5 (1997): 2484. http://dx.doi.org/10.1121/1.421040.
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Gibson, P. H. "Balloon angioplasty versus surgery." Radiology 185, no. 3 (1992): 908–9. http://dx.doi.org/10.1148/radiology.185.3.1438786.
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Deckelbaum, Lawrence I. "Balloon Catheter Coronary Angioplasty." Critical Care Medicine 16, no. 12 (1988): 1259. http://dx.doi.org/10.1097/00003246-198812000-00029.
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Liddicoat, A. J., and M. S. T. Ruttley. "Deflating an angioplasty balloon." Clinical Radiology 46, no. 2 (1992): 148–49. http://dx.doi.org/10.1016/s0009-9260(05)80334-4.
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Urschel, H. C., M. A. Razzuk, E. Miller, and S. Y. Chung. "Operative transluminal balloon angioplasty." Journal of Thoracic and Cardiovascular Surgery 99, no. 4 (1990): 581–89. http://dx.doi.org/10.1016/s0022-5223(19)36929-6.
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Albuquerque, Felipe C., George P. Teitelbaum, Sean D. Lavine, Donald W. Larsen, and Steven L. Giannotta. "Balloon-protected Carotid Angioplasty." Neurosurgery 46, no. 4 (2000): 918–23. http://dx.doi.org/10.1227/00006123-200004000-00027.
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