Drug-coated Balloons for Small Coronary Vessel Interventions: A Literature Review

Nestelberger, Thomas; Jeger, Raban

doi:10.15420/icr.2019.06.r3

Cited by 19 publications

(19 citation statements)

References 52 publications

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“…In parallel with our results, Jeger et al demonstrated the same benefits of DEB versus DES for small coronary artery disease PCI in an open-label randomized noninferiority trial 31. This finding is supported by recent reports emphasizing DEB is a promising technique for certain de novo coronary lesions, with improved safety and efficacy 32. According to Hirohata et al, directional atherectomy in conjunction with DEB improves outcomes in LCx ostial stenosis and could soon be considered as a stentless therapeutic option 33.…”

supporting

confidence: 90%

Predictors and 3‐year outcomes of compromised left circumflex coronary artery after left main crossover stenting

Ullah

Elakabawi

Han

et al. 2021

Clinical Cardiology

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Background: There are few predictors of decreased fractional flow reserve (FFR) in the left circumflex coronary artery (LCx) after left main (LM) crossover stenting.Objectives: We aimed to determine the predictors for low FFR at LCx and possible treatment strategies for compromised LCx, together with their long-term outcomes. Methods: Altogether, 563 patients who met the inclusion criteria were admitted to our hospital from February 2015 to November 2020 with significant distal LM bifurcation lesions. They underwent single-stent crossover percutaneous coronary intervention (PCI) under intravascular ultrasound (IVUS) guidance with further LCx intervention based on the measured FFR. Results: The patients showed significant angiographic LCx ostial affection post-LM stenting, but only 116 (20.6%) patients had FFR < 0.8. The three-year composite major adverse cardiac events (MACE) rates were comparable between the high and low FFR groups (16.8% vs. 15.5; p = 0.744). In a multivariate analysis, low FFR at the LCx was associated with post-stenting minimal luminal area (MLA) of LCx (odds ratio [OR]: 0.032, p < .001), post-stenting LCx plaque burden (OR: 1.166, p < .001), poststenting LM MLA (OR: 0.821, p = .038), and prestenting LCx MLA (OR: 0.371, p = .044). In the low FFR group, those with compromised LCx managed with drugeluting balloon had the lowest three-year MACE rate (8.1%), as compared to either those undergoing kissing balloon inflation (KBI) (17.5%) or stenting (20.5%) (p = 0.299). Conclusion: Unnecessary LCx interventions can be avoided with FFR-guided LCx intervention. Poststenting MLA and plaque burden of the LCx, and main vessel stent length are poststenting predictors of low FFR.

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supporting

confidence: 90%

Predictors and 3‐year outcomes of compromised left circumflex coronary artery after left main crossover stenting

Ullah

Elakabawi

Han

et al. 2021

Clinical Cardiology

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“…In the process of PCI treatment, whether it is the injury caused by balloon expansion to the intima or the mechanical stimulation generated by the stent, it may exert an activation effect on inflammatory factors, induce local inflammation, and then stimulate smooth muscle cells [27,28]. The proliferation reaction also causes a certain deposition of extracellular matrix, resulting in thickening of the intima and ISR [29]. Some doctors [30] have pointed out that both the diameter of the blood vessel and the length of the stent have a certain correlation with the ISR.…”

Section: Discussionmentioning

confidence: 99%

The characteristics and risk factors of in-stent restenosis in patients with percutaneous coronary intervention: what can we do

Wang

Qiao

Wang

et al. 2020

BMC Cardiovasc Disord

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Background Percutaneous coronary intervention (PCI) is a common treatment for patients with coronary heart disease, and intra-stent restenosis (ISR) is a serious complication after PCI. It’s necessary to identify the potential risk factors to provide evidence for the prevention of ISR. Methods The patients who underwent coronary angiography 1 year after PCI in our hospital from January 2017 to May 2019 were selected. The characteristics and results of clinical examination of ISR and no-ISR patients were compared, Multivariate logistic regression analyses were performed to identify the risk factors. Results A total of 209 patients were included, the incidence of ISR after PCI was 30.62%. There were significant differences on the hypertension, diabetes, number of coronary artery lesions, reasons for stent implantation, the diameter of stent, the length of stent and stent position between ISR group and no-ISR patients (all p < 0.05). The LDL-C in ISR groups was significantly higher than that of no-ISR group (p = 0.048), there were no significant differences between two groups in FPG, TG, TC, HDL-C, Apo A1, Apo B, LP-a and glycated haemoglobin (all p > 0.05). The hypertension (OR 4.30, 95% CI 1.12–9.34), diabetes (OR 5.29, 95% CI 1.25–9.01), number of coronary artery lesions ≥ 2 (OR 4.84, 95% CI 1.21–9.55), LDL-C ≥ 1.9 mmol/L (OR 5.93, 95% CI 2.29–10.01), unstable angina (OR 2.92, 95% CI 1.20–4.55), left anterior descending artery (OR 4.01, 95% CI 1.73–7.58), diameter of stent ≥ 3 mm (OR 5.42, 95% CI 1.24–10.84), the length of stent > 20 mm (OR 3.06, 95% CI 1.19–5.22) were the independent risk factor for ISR (all p < 0.05). Conclusion It is necessary to take preventive measures against these risk factors to reduce ISR, and studies with larger sample size and longer follow-up on this issue are needed in the future.

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“…Preclinical studies have demonstrated the successful delivery of sirolimus into the tunica medial layer, with some drugs extending into the adventitia (19). The DCB used in this study uses a unique phospholipid coating technology to allow for 100% sirolimus submicron drug particle coating on the balloon surface to facilitate controlled drug delivery into the vessel wall when the balloon is inflated (20).…”

Section: Discussionmentioning

confidence: 99%

Single-Center Prospective Pilot Study of Sirolimus Drug-Coated Balloon Angioplasty in Maintaining the Patency of Thrombosed Arteriovenous Graft

Tan

Pang

et al. 2021

Journal of Vascular and Interventional Radiology

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Drug-coated Balloons for Small Coronary Vessel Interventions: A Literature Review

Cited by 19 publications

References 52 publications

Predictors and 3‐year outcomes of compromised left circumflex coronary artery after left main crossover stenting

Predictors and 3‐year outcomes of compromised left circumflex coronary artery after left main crossover stenting

The characteristics and risk factors of in-stent restenosis in patients with percutaneous coronary intervention: what can we do

Single-Center Prospective Pilot Study of Sirolimus Drug-Coated Balloon Angioplasty in Maintaining the Patency of Thrombosed Arteriovenous Graft

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