Instent restenosis after carotid stenting: treatment using an off-label cardiac scoring balloon

Abstract

Background—Treatment of instent restenosis after carotid artery stenting because of circumferential or
calcified lesions can be difficult and refractory to conventional balloon angioplasty. We describe the offlabel use of a cardiac scoring balloon that was used for lesions refractory to angioplasty with other balloons.
Case descriptions—Two patients with a history of carotid artery stenting 6 and 8 years ago, presented
with symptomatic carotid instent restenosis caused by circumferential and calcified lesions, respectively.
Angioplasty with conventional compliant and noncompliant balloons was unsuccessful. An AngioSculpt
percutaneous transluminal coronary angioplasty (PTCA) scoring balloon catheter (AngioScore, Fremont
CA, USA) was successful in achieving vessel recanalization despite the refractory nature of these lesions.
No further conventional balloons or use of cutting balloons was required.
Conclusion—The AngioSculpt PTCA scoring balloon catheter can be a useful option for treatment of
refractory calcified or circumferential carotid instent restenosis.