A multicenter randomized comparison of drug‐eluting balloon plus bare‐metal stent versus bare‐metal stent versus drug‐eluting stent in bifurcation lesions treated with a single‐stenting technique: Six‐month angiographic and 12‐month clinical results of the drug‐eluting balloon in bifurcations trial

Stella, Pieter R.; Belkacemi, Anouar; Dubois, Christophe; Nathoe, Hendrik M.; Dens, Jo; Naber, Christoph; Adriaenssens, Tom; Belle, Éric Van; Doevendans, Pieter A.; Agostoni, Pierfrancesco

doi:10.1002/ccd.23499

Cited by 101 publications

(63 citation statements)

References 26 publications

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“…However, dedicated bifurcation devices supporting a two-stent technique could shift the current paradigm and make the two-stent approach the preferred strategy, especially in certain lesion subtypes such as true bifurcations with extensive side branch disease [27]. On the other hand, dedicated bifurcation devices facilitating a single-stent approach or adjunctive use of drug-eluting balloons [28] could improve clinical outcomes of the single-stent technique. More RCTs on dedicated devices are therefore needed to clarify whether dedicated devices improve clinical outcomes, and whether a provisional single-stent approach is still the preferred strategy with the availability of new dedicated devices.…”

Section: Discussionmentioning

confidence: 99%

Six-month clinical outcomes of the Tryton Side Branch Stent for the treatment of bifurcation lesions

et al. 2012

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Aims Percutaneous coronary intervention (PCI) of a bifurcation lesion (BL) is still associated with poorer clinical outcomes when compared with PCI of a non-BL. Therefore, several dedicated coronary bifurcation stents, such as the Tryton Side Branch Stent™ (Tryton Medical, Durham, NC, USA), were developed to improve clinical outcomes. We investigated 6-month clinical outcomes after placement of a Tryton stent in 91 patients treated for 93 BLs in our centre. Methods and results All consecutive patients who have undergone PCI of a BL treated with the Tryton stent in our centre were included. Outcomes were defined as any death, cardiac death, myocardial infarction (MI), any revascularisation, ischaemia-driven target vessel revascularisation (TVR), ischaemia-driven target lesion revascularisation (TLR), stent thrombosis, and target vessel failure (TVF; composite of cardiac death, MI, and ischaemia-driven TVR). Event rates were estimated using the Kaplan-Meier method. Thirty-eight (42 %) patients with acute coronary syndrome (ACS) were included (16 % ST-segment elevation MI (STEMI)). The 6-month event rates were 5.4 % (death), 4.3 % (cardiac death), 2.2 % (MI), 4.5 % (any revascularisation), 4.5 % (TVR), 4.5 % (TLR) and 9.7 % (TVF). ConclusionIn a real-world all-comers single-centre registry, the use of the Tryton Side Branch Stent was associated with acceptable procedural and promising clinical outcomes at 6 months, including ACS and STEMI patients.

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Section: Discussionmentioning

confidence: 99%

Six-month clinical outcomes of the Tryton Side Branch Stent for the treatment of bifurcation lesions

et al. 2012

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“…Following screening for replicates, 405 remained; and after screening abstracts for relevance, a further 371 studies were removed. Finally, full text of the remaining 34 studies were screened, of which 17 randomised controlled trials (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34) fulfilled the inclusion criteria and were qualitatively and quantitatively analysed.…”

Section: Resultsmentioning

confidence: 99%

“…Additionally, any future studies of DEB must be against the latest generation of DES so that a valid comparison can be made against the technology in current clinical use. Finally, some studies were susceptible to industry bias owing to author involvement in relevant device companies such as B. Braun, Boston Scientific Medtronic and Eurocor GmbH (18,21,22,28,29,31,33). Similarly, conflicts of interest may have arisen due to these companies funding studies which investigated their own products (18,21,26,28,30,31,33,34).…”

Section: Limitationsmentioning

confidence: 99%

Drug-eluting balloons with provisional bail-out or adjunctive stenting in de novo coronary artery lesions—a systematic review and meta-analysis

Patel

Svermova

Burke-Gaffney

et al. 2018

Cardiovasc. Diagn. Ther.

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Background: Efficacy of drug-eluting balloons (DEB) for treatment of de novo coronary lesions remains controversial. The present systematic review and meta-analysis of randomised controlled trials assessed DEB with bare-metal stents (BMS) and also DEB with provisional bail-out stents ('DEB-only' strategy), to other conventional options: plain-old balloon angioplasty (POBA), BMS and drug-eluting stents (DES). Conclusions:The results of this meta-analysis showed that whilst DEB with BMS is superior to BMS alone, the combination is inferior to DES for treatment of de novo coronary lesions. Thus, DEB + BMS should not be applied in de novo lesions unless in patients who have absolute contraindications to DES. DEB alone, however, should be considered for relative contraindications to DES such as small vessel disease and bifurcation lesions.

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“…However, in cohorts with intermediate and high risk, such as in the context of complex (35), (85), (86), (87), (88), (89) (90), (89), (90) (35), (41), (87), (92), (93) (48), (94), (95), (90), (96), (97) (48), (98), (99), (100), (101), (102), (97) (103), (104) …”

Section: Discussionmentioning

confidence: 99%

Progress in interventional cardiology: challenges for the future

Simsekyilmaz¹,

Liehn²,

Militaru³

et al. 2015

Thromb Haemost

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SummaryCardiovascular disease is the leading cause of death in the western and developing countries. Percutaneous transluminal coronary interventions have become the most prevalent treatment option for coronary artery disease; however, due to serious complications, such as stent thrombosis and in-stent restenosis (ISR), the efficacy and safety of the procedure remain important issues to address. Strategies to overcome these aspects are under extensive investigation. In this review, we summarise relevant milestones during the time to overcome these limitations of coronary stents, such as the development of polymer-free drug-eluting stents (DES) to avoid pro-inflammatory response due to the polymer coating or the developement of stents with cell-directing drugs to, simultaneously, improve re-endothelialisation and inhibit ISR amongst other techniques most recently developed, which have not fully entered the clinical stage. Also the novel concept of fully biodegradable DES featured by the lack of a permanent foreign body promises to be a beneficial and applicable tool to restore a natural vessel with maintained vasomotion and to enable optional subsequent surgical revascularisation.

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Abstract: Pretreatment of both MB and SB with DEB failed to show angiographic and clinical superiority over conventional BMS, using a provisional T-stenting technique. Moreover DES showed superior angiographic results than DEB and BMS.

Cited by 101 publications

References 26 publications

Six-month clinical outcomes of the Tryton Side Branch Stent for the treatment of bifurcation lesions

Six-month clinical outcomes of the Tryton Side Branch Stent for the treatment of bifurcation lesions

Drug-eluting balloons with provisional bail-out or adjunctive stenting in de novo coronary artery lesions—a systematic review and meta-analysis

Progress in interventional cardiology: challenges for the future

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