Successful dilation using a Non-Slip Element Percutaneous Transluminal Angioplasty Scoring Balloon to treat in-stent restenosis of carotid artery stenting with inadequate dilation during balloon angioplasty:A case report.

Background: Carotid artery stenting (CAS) is commonly performed to treat internal carotid artery (ICA) stenosis;however, it is associated with high recurrence rates. The treatment of in-stent restenosis (ISR) following CAS poses several challenges, and percutaneous transluminal angioplasty (PTA) is a possible treatment option. Scoring balloons used in the cardiovascular field can prevent slipping and plaque incisions during balloon expansion;however, their efficacy in treating cervical ICA ISR remains uncertain.

Case Description: An 81-year-old man underwent CAS for carotid artery stenosis and subsequently developed ISR. Initial PTA with a noncompliant balloon failed to achieve sufficient dilation. However, the employment of a non-slip-element (NSE) PTA scoring balloon for additional expansion resulted in successful dilation, indicating its effectiveness in treating cervical ICA ISR. The patient was discharged postoperatively without any new neurological deficits, although magnetic resonance imaging revealed new ischemic lesions.

Conclusion: The NSE PTA balloon could be considered as a valuable and effective treatment option for ISR when conventional balloon catheters face challenges in achieving dilation, although potential risks such as debris embolization should be considered. J. Med. Invest. 71 : 303-305, August, 2024.