Effectiveness of Cutting Balloon Angioplasty for Small Vessels Less than 3.0 mm in Diameter

Muramatsu, Toshiya; Tsukahara, Reiko; Ho, Mami; Hirano, Keisuke; Nakano, Masatugu; Matsushita, Masashiro

doi:10.1111/j.1540-8183.2002.tb01104.x

Cited by 5 publications

(4 citation statements)

References 8 publications

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“…Cutting the balloon can reduce postoperative elastic retraction of the vessel and lumen loss due to a lack of bracing [ 41 , 42 ]. Compared to conventional balloons, predilation with cutting balloon was proven to be able to reduce the incidence of severe dissections (types E and F) [ 43 , 44 ].…”

Section: Advantages and Disadvantages Of The Dcb-only Strategy In Ppcimentioning

confidence: 99%

Drug-Coated Balloon in Primary Percutaneous Coronary Intervention

Zhao

Miao

Lin

et al. 2023

Journal of Interventional Cardiology

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According to the latest coronary interventional guidelines, a drug-eluting stent is the recommended reperfusion therapy in primary percutaneous coronary intervention (pPCI). However, deficiencies and defects, such as in-stent restenosis (ISR), incomplete stent apposition, stent thrombosis, reinfarction after stent implantation, long-term dual antiplatelet drug use, and adverse reactions of metal implants, plague clinicians and patients. Drug-coated balloon (DCB), which delivers antiproliferative agents into the vessel wall without stent implantation and leaves no implants behind after the procedure, is a novel option for percutaneous coronary intervention and has proven to be a promising strategy in cases of ISR, small vessel coronary artery disease, and bifurcation lesions. However, most of the available experience has been gained in elective percutaneous coronary intervention, and experience in pPCI is lacking. The current evidence for the use of DCB-only in pPCI was discussed and analyzed in this review.

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Section: Advantages and Disadvantages Of The Dcb-only Strategy In Ppcimentioning

confidence: 99%

Drug-Coated Balloon in Primary Percutaneous Coronary Intervention

Zhao

Miao

Lin

et al. 2023

Journal of Interventional Cardiology

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“…But cutting balloon also has some defects, it is easy to induce coronary dissection and perforation, meanwhile, the plaque shed off could lead to stent thrombosis, so cutting balloon is mainly used for non-calci ed centripetal stenosis lesions, in-stent restenosis and bifurcation lesions [9][10][11][12]. Drug coated balloon (DCB) is a plain balloon coating with anti-proliferative drugs, it can extrude the drug into the vessel during balloon expansion process, to ensure adequate drug dissolved and permeate to the vessel walls, so as to realize the early anti-proliferation effect to the vascular.…”

Section: Introductionmentioning

confidence: 99%

A novel ultrasound controlled paclitaxel releasing balloon catheter versus plain balloon catheter in the treatment of small coronary vessel stenosis: study protocol of a randomized controlled clinical trial (Vasoguard I Trial)

Pan

Zhang

Wang

et al. 2020

Preprint

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Background The optimal intervention strategy remains controversial in small vessel disease which is a very common kind of coronary artery lesions. For now, balloon-only percutaneous coronary intervention is the major percutaneous revascularization method in these patients, but the restenosis rate is still at a high level. Drug coated balloon is designed to deliver paclitaxel to target vessel to inhibit the proliferation of vascular endothelial cells, it aims at restraining the stenosis process after intervention so as to reduce the rate of restenosis. Ultrasound controlled paclitaxel releasing balloon catheter (Vasoguard TM ) is a newly designed drug coated balloon, expected to promote the drug release process via external ultrasound intervention so as to improve drug bioavailability. The current trial was designed to assess the efficacy and safety of Vasoguard in the treatment of small vessel coronary disease.Methods A prospective, multicenter, randomized, controlled clinical trial has been designed to compare the safety and efficacy of Vasoguard with plain balloon angioplasty in the treatment of small vessel coronary disease. 230 patients will be included in this trial, the primary endpoint is late lumen loss of target lesion at 9 months post operation measured by quantitative coronary angiography. Secondary endpoints include angiographic findings such as device success rate, operation success rate, in-segment restenosis, clinical outcomes such as target lesion revascularization, target vessel revascularization, device oriented composite endpoint and thrombotic events.Discussion This trial will evaluate the efficacy and safety of Vasoguard in the treatment of small vessel coronary disease by comparing to plain balloon angioplasty. It will clarify the practicability of the newly designed balloon and may lend more credence to the role of drug coated balloon in the treatment of small vessel disease.

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“…Although percutaneous transluminal coronary angioplasty is widely accepted as an effective treatment in patients with coronary ischemia, the treatment has been limited by high rates of restenosis, reported in up to 40% of all treated lesions 1,2 and half of treated lesions in small coronary arteries. 3,4 Metallic stents reduced the rate of restenosis by approximately 10%, but, even lately, the rate of restenosis remains at nearly 30%, and rate of target lesion revascularization reaches nearly Restenosis after percutaneous coronary interventional procedures is chiefly due to elastic recoil and inflammatory reactions resulting in cell proliferation and intimal hyperplasia. Hereby, coronary stenting is thought to reduce the rate of restenosis mainly by reducing elastic recoil.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hydrocortisone Reduces Restenosis After Stenting of Small Coronary Arteries

Kakio¹,

Matsumori²,

Ohashi³

et al. 2004

J Interven Cardiology

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Stenting of small coronary arteries has been limited by high rates of restenosis, and restenosis after stenting has chiefly been attributed to inflammatory reactions resulting in cell proliferation and intimal hyperplasia. In order to suppress this inflammatory process, we examined the effects of hydrocortisone, an antiinflammatory agent, on restenosis after stenting in a nonrandomized retrospective registry. The study population consisted of 193 patients treated at two hospitals, who underwent stent implantations in coronary arteries of reference diameter <3 mm between February 1999 and September 2001. Target lesions included complex, restenotic, diabetic, or chronic total lesions and types of implanted stents were Multi-Link, S-series, and gfx stents. Effect of intravenous administration of hydrocortisone (200 mg) before stenting was compared to control patients who did not receive this treatment. There was no significant difference of early outcomes between the hydrocortisone group and the control group. On angiographic follow-up at 6 months after stenting, the rate of restenosis was significantly lower in patients treated with hydrocortisone as compared with control group (22.8% vs 37%, respectively; P < 0.05). The revascularization rate of target lesion at 6 months was also significantly lower in the treated group (16.5% vs 29%, respectively; P < 0.05). These results suggest that preprocedural intravenous administration of hydrocortisone reduces restenosis after stenting of small coronary arteries. Prospectively controlled trials will be necessary to confirm this preventive effect of hydrocortisone on coronary in-stent restenosis.

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Effectiveness of Cutting Balloon Angioplasty for Small Vessels Less than 3.0 mm in Diameter

Cited by 5 publications

References 8 publications

Drug-Coated Balloon in Primary Percutaneous Coronary Intervention

Drug-Coated Balloon in Primary Percutaneous Coronary Intervention

A novel ultrasound controlled paclitaxel releasing balloon catheter versus plain balloon catheter in the treatment of small coronary vessel stenosis: study protocol of a randomized controlled clinical trial (Vasoguard I Trial)

Hydrocortisone Reduces Restenosis After Stenting of Small Coronary Arteries

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