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Plaque modification and stabilization after drug-coated balloon angioplasty for intracranial atherosclerotic lesions

  • Vascular-Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

A drug-coated balloon (DCB) has potential applications in the treatment of intracranial atherosclerotic disease (ICAD). We aimed to evaluate changes of vessel wall features of ICAD lesions after DCB treatment by using vessel wall MRI (VWMRI).

Methods

We retrospectively included patients with symptomatic ICAD who underwent DCB angioplasty alone. The incidences of stenosis of the lumen area, vessel wall thickening, hyperintense plaques, and prominent wall enhancement were compared between the baseline and follow-up VWMRI.

Results

There were 29 ICAD lesions from 29 patients, of which 22 were stenosis and 7 were occlusion. The median interval between DCB treatment and follow-up VWMRI was 4.1 [3.3, 6.7] months. After DCB treatment, follow-up VWMRI showed a significant decrease in the stenosis degree of the lumen area (83% [71%, 96%] vs 15% [3%, 41%], p < 0.001). Thirty-eight percent (11/29) of the patients observed normal appearance of the target vessel wall on follow-up VWMRI. In the stenosis group, the prevalence of hyperintense plaques decreased from 66.7% (14/21) at baseline to 23.8% (5/21) at follow-up, and prominent wall enhancement decreased from 66.7% (14/21) at baseline to 19.0%(4/21) at follow-up. The incidence of hyperintense plaques (p = 0.028) and vessel wall thickening (p = 0.018) tended to decrease with follow-up time. Although not significant (p = 0.106), a similar trend was observed between the incidence of prominent wall enhancement and follow-up time.

Conclusion

Vascular healing with plaque modification and stabilization occurred following DCB treatment of ICAD lesions.

Key Points

• A drug-coated balloon (DCB) has potential applications in the treatment of intracranial atherosclerotic disease (ICAD).

• Vascular healing with plaque modification and stabilization occurred following DCB treatment of ICAD lesions.

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Abbreviations

3D:

Three-dimensional

BA:

Basilar artery

DCB:

Drug-coated balloon

ICA:

Intracranial internal carotid artery

ICAD:

Intracranial atherosclerotic disease

MCA:

Middle cerebral arteries

MRA:

MR angiography

MSI:

Mean signal intensity

TIA:

Transient ischemic attack

TIMI:

Thrombolysis in myocardial infarction

VA:

Vertebral arteries

VWMRI:

Vessel wall MRI

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Funding

No funding was received for this study.

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Authors and Affiliations

  1. Department of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, 16766 Jingshi Road, Jinan, 250014, Shandong, China

    Yao Meng, Yuyan Zhang, Xi Chu, Yun Song, Wei Zhao, Meimei Zheng, Jun Zhang & Ju Han

Authors
  1. Yao Meng
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  2. Yuyan Zhang
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  3. Xi Chu
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  4. Yun Song
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  5. Wei Zhao
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  6. Meimei Zheng
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  7. Jun Zhang
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  8. Ju Han
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Corresponding author

Correspondence to Ju Han.

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Guarantor

The scientific guarantor of this publication is Prof. Dr. Ju Han.

Conflict of interest

The authors have no conflicts of interest to declare.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was not required due to the retrospective and observational nature of this study.

Ethical approval

Institutional Review Board approval was obtained with an ID of 2021S1060.

Methodology

• retrospective

• observational

• performed at one institution

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Meng, Y., Zhang, Y., Chu, X. et al. Plaque modification and stabilization after drug-coated balloon angioplasty for intracranial atherosclerotic lesions. Eur Radiol 33, 1112–1120 (2023). https://doi.org/10.1007/s00330-022-09129-z

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  • DOI: https://doi.org/10.1007/s00330-022-09129-z

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