Favorable Vasomotor Function after Drug-Coated Balloon-Only Angioplasty of De Novo Native Coronary Artery Lesions

Kim, Sunwon; Lee, Jong-Seok; Kim, Yong Hyun; Kim, Jin-Seok; Lim, Sang-Yup; Kim, Seong Hwan; Kim, Minjung; Ahn, Jeong-Cheon; Song, Woo-Hyuk

doi:10.3390/jcm11020299

Cited by 10 publications

(6 citation statements)

References 31 publications

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“…One of the explanations for the favourable outcomes of DCB in diffuse coronary disease could come from another study, which evaluated the vessel vasomotor function after DCB 43 . In this study, the authors reported that the vasomotor response of the treated vessels was similar between the treated segments and angiographically normal segments (p=0.17), supporting the safety of a DCBonly strategy in treating de novo native coronary lesions.…”

Section: Figure 1 Three-year Clinical Outcomes Of the Piccoleto II Tr...mentioning

confidence: 99%

A 2024 scientific update on the clinical performance of drug-coated balloons

Lazar,

Onea,

Olinic

et al. 2024

AsiaIntervention

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Continuous advances in the field of interventional cardiology have led to the development of drug-coated balloons (DCB). These represent a promising device for overcoming the well-known limitations of traditional metallic stents, which are associated with a persistent yearly increased risk of adverse events. This technology has the ability to homogeneously transfer the drug into the vessel wall in the absence of a permanent prosthesis implanted in the coronary vessel.Robust data support the use of DCB for the treatment of in-stent restenosis, but there is also currently growing evidence from long-term follow-up of large randomised clinical trials regarding the use of these devices in other scenarios, such as de novo small and large vessel disease, complex bifurcations, and diffuse coronary disease. Other critical clinical settings such as diabetes mellitus, high bleeding risk patients and acute coronary syndromes could be approached in the upcoming future by using DCB, alone or as part of a blended strategy in combination with drug-eluting stents.There have been important scientific and technical advances in the DCB field in recent years. The purpose of this paper is to review the most current data regarding the use of DCB, including the mid-and long-term follow-up reports on the safety and efficacy of this novel strategy in different clinical and angiographic scenarios.

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Section: Figure 1 Three-year Clinical Outcomes Of the Piccoleto II Tr...mentioning

confidence: 99%

A 2024 scientific update on the clinical performance of drug-coated balloons

Lazar,

Onea,

Olinic

et al. 2024

AsiaIntervention

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“…The use of drug-coated balloons (DCBs) in treating patients with in-stent restenosis [ 14 ] and de novo small vessel disease [ 15 , 16 ] has demonstrated comparable clinical outcomes to DES implantation. Unlike DES implantation, the DCB strategy leaves no material behind, thereby reducing the risk of stent-related adverse biological reactions that can lead to restenosis and thrombosis [ 17 ]. This approach promotes vascular healing.…”

Section: Introductionmentioning

confidence: 99%

Impact of Drug-Coated Balloon-Based Revascularization in Patients with Chronic Total Occlusions

Shin,

Her,

Jang

et al. 2024

JCM

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Background: Percutaneous coronary intervention (PCI) with a drug-eluting stent (DES) for chronic total coronary occlusions (CTOs) improves clinical symptoms and quality of life. However, data on drug-coated balloon (DCB)-based PCI in CTO lesions are limited. Methods: A total of 200 patients were successfully treated for CTO lesions, either with DCB alone or in combination with DES (DCB-based PCI). They were compared with 661 patients who underwent second-generation DES implantation for CTO from the PTRG-DES registry (DES-only PCI). The endpoint was major adverse cardiovascular events (MACEs), which included a composite of cardiac death, myocardial infarction, stent or target lesion thrombosis, target vessel revascularization, and major bleeding at 2 years. Results: In the DCB-based PCI group, 49.0% of patients were treated with DCB only and 51.0% underwent the hybrid approach combining DCB with DES. Bailout stenting was performed in seven patients (3.5%). The DCB-based PCI group exhibited fewer stents (1.0; IQR: 0.0–1.0 and 2.0; IQR: 1.0–3.0, p < 0.001), shorter stent lengths (6.5 mm; IQR: 0.0–38.0 mm and 42.0 mm; IQR: 28.0–67.0 mm, p < 0.001), and lower usage of small stents with a diameter of 2.5 mm or less (9.8% and 36.5%, p < 0.001). Moreover, the DCB-based PCI group had a lower rate of MACEs than the DES-only PCI group (3.1% and 13.2%, p = 0.001) at 2-year follow-up. Conclusions: The DCB-based PCI approach significantly reduced the stent burden, particularly in the usage of small stent diameters, and resulted in a lower risk of MACEs compared to DES-only PCI in CTO lesions.

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“…Drug-eluting stents (DESs) have been associated with a number of pitfalls since their inception, including stent thrombosis [ 11 , 12 ], neo-atheroma [ 13 ], prolonged mandated dual antiplatelet therapy [ 14 , 15 ], and impaired vasoreactivity causing endothelial dysfunction [ 16 , 17 ]. Drug-coated balloons (DCBs) are a guideline-recommended treatment for in-stent restenosis (ISR), with a growing amount of data demonstrating their long-term efficacy in small-vessel de novo disease [ 18 , 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Drug-Coated Balloon vs. Drug-Eluting Stents for De Novo Unprotected Left Main Stem Disease: The SPARTAN-LMS Study

Gunawardena

Corballis

Merinopoulos

et al. 2023

JCDD

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The objective of this study is to compare the outcomes of patients treated with drug-coated balloons (DCBs) or second-generation drug-eluting stents (DESs) for de novo unprotected left main stem (LMS) disease. Previous studies comparing the treatment of LMS disease suggest that the mortality for DES PCI is not worse than CABG. There are limited data from studies investigating the treatment of de novo LMS disease with DCB angioplasty. We compared the all-cause and cardiac mortality of patients treated with paclitaxel DCB to those with second-generation DES for de novo LMS disease from July 2014 to November 2019. Data were analysed using Kaplan–Meier analyses and propensity-matched analyses. A total of 148 patients were treated with either a DCB or DES strategy. There was no significant difference in all-cause mortality in the DCB group (19.5%) compared to the DES group (15.9%) (HR 1.42 [0.61–3.32], p = 0.42). Regarding cardiac mortality, 2 (4.9%) were recorded for the DCB group and 7 (6.5%) for the DES group (HR 1.21 [0.31–4.67], p = 0.786); for target vessel myocardial infarction, there were 0 (0%) for the DCB group and 7 (6.5%) for the DES group; and for target lesion revascularisation, there were 3 (7.3%) in the DCB group and 9 (8.3%) in the DES group (HR: 0.89 [0.24–3.30]). p = 0.86. These remained not significant after propensity score matching. We found no difference in the mortality outcomes with DCB angioplasty compared to second-generation DES, with a median follow-up of 33 months. DCB can therefore be regarded as a safe option in the treatment of LMS disease in suitable patients.

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Favorable Vasomotor Function after Drug-Coated Balloon-Only Angioplasty of De Novo Native Coronary Artery Lesions

Cited by 10 publications

References 31 publications

A 2024 scientific update on the clinical performance of drug-coated balloons

A 2024 scientific update on the clinical performance of drug-coated balloons

Impact of Drug-Coated Balloon-Based Revascularization in Patients with Chronic Total Occlusions

Drug-Coated Balloon vs. Drug-Eluting Stents for De Novo Unprotected Left Main Stem Disease: The SPARTAN-LMS Study

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