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Lasers in Cardiovascular Interventions pp 171–179Cite as

Laser Synergism with Drug Eluting Balloon for Treatment of In-Stent Restenosis in the Lower Extremities

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Abstract

Restenosis, and in particular in-stent restenosis, remains a problem that significantly affects mid- and long-term outcome of all endovascular procedures, and especially procedures that involve the superficial femoral and popliteal artery. This chapter will provide a description of the process of (in-stent) restenosis with special attention to the histopathological changes that occur. Furthermore it will give an overview of the current status of drug-eluting balloon technology. It will describe the technique of the treatment of in-stent restenosis of the infrainguinal arteries, using a combined technique of laser debulking (atherectomy) followed by drug-eluting balloon angioplasty. Personal experience as well as the results of this technique as described in the literature will be discussed. A comparison with other techniques such as drug-eluting balloon angioplasty as stand-alone therapy or mechanical atherectomy as single therapy will be made. It is concluded that in the treatment of in-stent restenosis, debulking is probably key. There is a growing body of evidence that by adding drug-eluting balloon angioplasty to debulking results can be achieved that compare favorable to those described in the literature that were obtained with standard balloon angioplasty, cutting-balloon angioplasty or debulking alone.

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Authors and Affiliations

  1. Service of Interventional Radiology, Ospedale Regionale di Lugano, Via Tesserete 46, Lugano, 6903, Switzerland

    Jos C. van den Berg MD, PhD

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  1. Jos C. van den Berg MD, PhD
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Correspondence to Jos C. van den Berg MD, PhD .

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Editors and Affiliations

  1. Division of Cardiology, Charles George VA Medical Center, Asheville, North Carolina, USA

    On Topaz

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van den Berg, J.C. (2015). Laser Synergism with Drug Eluting Balloon for Treatment of In-Stent Restenosis in the Lower Extremities. In: Topaz, O. (eds) Lasers in Cardiovascular Interventions. Springer, London. https://doi.org/10.1007/978-1-4471-5220-0_13

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  • DOI: https://doi.org/10.1007/978-1-4471-5220-0_13

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-5219-4

  • Online ISBN: 978-1-4471-5220-0

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