Influence of residual stenosis in determining restenosis after cutting balloon angioplasty

Martı́, Vicens; Salas, Elena; Aymat, Rosa M.; Garcı́a, Joan; Guiteras, Pere; Romeo, Isabel; Kozak, Fernando; Augé, Josep M.

doi:10.1002/(sici)1522-726x(200004)49:4<410::aid-ccd13>3.0.co;2-x

Cited by 11 publications

(6 citation statements)

References 21 publications

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“…Residual stenosis predicts restenosis after CBA. 37 Therefore, the favorable initial procedural result could have contributed to this favorable outcome on restenosis. 38 Our data do not confirm previous results reporting an excellent correlation of clinical and angiographic restenosis rates in stented patients.…”

Section: Discussionmentioning

confidence: 99%

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Clinical and Angiographic Outcome after Cutting Balloon Angioplasty

Auer

Maurer

Baldassano

et al. 2003

J Interven Cardiology

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The cutting balloon is a new device for coronary angioplasty, that, by the combination of incision and dilatation of the plaque, is believed to be promising for treatment of in-stent restenosis. The purpose of the study was to evaluate the safety and efficacy of CBA. We reviewed the immediate and 6-month follow-up angiographic and clinical outcome of 147 patients (109 men and 38 women) with a mean age of 67.3 +/- 10 undergoing this procedure at eight interventional centers in Austria. The target lesions treated with CBA were in-stent restenosis in 61% of patients, stenosis after balloon angioplasty in 8% of patients, and native lesions in 33% of patients. Sixty-five percent of the patients included had multivessel disease. Lesion type was A in 18% of patients, B1 in 31% of patients, B2 in 39% of patients, and C in 12% of patients. The degree of stenosis was 87% +/- 9%, the length of the target lesion treated with CBA was 8.8 +/- 5.1 mm. Target vessel was left circumflex artery in 22 cases, right coronary artery in 36 cases, and left anterior descending artery in 89 cases. The overall procedural success rate was 90.5%. "Stand-alone" CBA was performed in 63% of patients, the procedure was combined with coronary stenting in 16% of patients, and with balloon angioplasty in 21% of patients. Coronary complications occurred in eight cases (5.4%) with coronary dissection in seven (total dissection rate of 4.7%) and urgent bypass surgery in one case (0.7%). No further complications such as death, occlusion, or perforation of coronary arteries, embolization, or thrombosis were observed. Six-month clinical follow-up revealed q-wave myocardial infarction in 2.7% of patients, aortocoronary bypass surgery in 8.5% of patients, and repeated percutaneous coronary intervention in 17% of patients (11.5% with stenting). Six-month angiographic follow-up of patients with recurrent angina showed target lesion restenosis (> 50% diameter stenosis) in 14% of patients, late lumen loss with < or = 50% diameter stenosis in 6% of patients and progression of "other than target" lesions with > 50% diameter stenosis in 14% of patients. This series demonstrates the safety and feasibility of cutting balloon angioplasty in patients with complex coronary artery disease and in-stent restenosis.

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Section: Discussionmentioning

confidence: 99%

“…The rate of residual diameter stenosis >50% after CBA was 4.2%. Residual stenosis predicts restenosis after CBA 37 . Therefore, the favorable initial procedural result could have contributed to this favorable outcome on restenosis 38 .…”

mentioning

confidence: 99%

Clinical and Angiographic Outcome after Cutting Balloon Angioplasty

Auer

Maurer

Baldassano

et al. 2003

J Interven Cardiology

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“…22,23 The postprocedural residual stenosis was higher in the cutting balloon group (17.2±21.5% vs 6.4±13.1%, p=0.04). The degree of postprocedural residual stenosis after cutting balloon angioplasty is predictive of late restenosis, 24 and to decrease the restenosis rate, it is important to optimize the angiographic result after cutting balloon angioplasty with adjunctive balloon or stenting. A case example of cutting balloon used in a branch ostial lesion is shown in Fig 3.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Cutting Balloon vs Stenting Alone in Small Branch Ostial Lesions of Native Coronary Arteries.

Chung

Nakamura

Takada

et al. 2003

Circ J

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Angioplasty of small vessels is associated with a higher rate of restenosis, even in the ostium. The present study compared the acute, late results of cutting balloon vs those of stenting alone in small branch ostial lesions of native coronary arteries and the effect on the parent vessel. The study group comprised 61 patients with successful angioplasty of smaller branch ostial lesions in native coronary arteries. The reference vessel diameter was between 2.5 and 3.0 mm. Patients were divided into 2 groups: group I (cutting balloon, n=30) and group II (stenting alone, n=31). After intervention, patients in group II achieved significant acute lumen gain, larger minimal lumen diameter (MLD) and less diameter stenosis. At 3-month follow-up, the MLD and diameter stenosis of the 2 groups were almost identical; however, late loss was lower in group I. At the 6-month follow up, the cumulative restenosis rate was 41% (11/27) in group I compared with 63% (19/31) in group II (p=0.05), and the target lesion revascularization was also lower in the cutting balloon group [29% (8/27) vs 53% (16/30) p=0.05]. In group 1, the MLD of the parent vessel did not change before, after cutting balloon or at follow-up. In contrast, there were significant reductions in parent vessel MLD following stenting alone and at follow-up. Plaque shift did not occur in the cutting balloon group. Cutting balloon angioplasty is a feasible approach for the treatment of small branch ostial lesions and does not cause significant narrowing of the parent vessel.

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“…36,37 Cutting balloon angioplasty has been proven to be a safe and effective treatment of lesion restenosis, with significantly higher patency than that of conventional balloon angioplasty. 38,39 In addition, the first application of Vasoguard TM DCB is an important guarantee. Clinical performances of different DCBs are determined by crystal state and dose of paclitaxel, excipient and coating properties.…”

Section: Patient Medicationmentioning

confidence: 99%

New Ultrasound-Controlled Paclitaxel Releasing Balloon vs. Asymmetric Drug-Eluting Stent in Primary ST-Segment Elevation Myocardial Infarction　― A Prospective Randomized Trial ―

Wang¹,

Yin

Li³

et al. 2022

Circ J

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the agent is rapidly released locally into the vessel wall. 9 This technology allows a broader area of surface contact and more homogenous drug-tissue transfer compared to stent-based local drug delivery. 10 CAD patients treated with DCB angioplasty may benefit from the absence of a permanent stent and shortened dual antiplatelet therapy. 11-13 DCB application was first recommended by the European Society of Cardiology (ESC) and European Association for Cardio-Thoracic Surgery (EACTS) guidelines for the treatment of in-stent restenosis (ISR) after prior bare-metal stent (BMS) (Class IIA, Level B) implantation in 2010. 14 Thereafter, DCBs were recommended by the ESC/EACTS guidelines for the treatment of ISR S ince the 1970s, the invention of balloon angioplasty and percutaneous coronary intervention (PCI) have made rapid progress in the treatment of occlusive coronary artery disease (CAD). 1,2 In particular, drug-eluting stents (DES) have become an optimal strategy for the benefit of quickly recovering coronary artery blood flow, inhibiting restenosis. However, endothelial dysfunction, neo-atherosclerosis and thrombosis followed by DES implantation greatly affect the efficacy of clinical prognosis. 3-5 The permanent existence of stent platforms is considered as the main reason. 6-8 Drug-coated balloons (DCBs) are semi-compliant angioplasty balloons covered with an antiproliferative lipophilic agent. When DCB is inflated,

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Influence of residual stenosis in determining restenosis after cutting balloon angioplasty

Cited by 11 publications

References 21 publications

Clinical and Angiographic Outcome after Cutting Balloon Angioplasty

Clinical and Angiographic Outcome after Cutting Balloon Angioplasty

Comparison of Cutting Balloon vs Stenting Alone in Small Branch Ostial Lesions of Native Coronary Arteries.

New Ultrasound-Controlled Paclitaxel Releasing Balloon vs. Asymmetric Drug-Eluting Stent in Primary ST-Segment Elevation Myocardial Infarction　― A Prospective Randomized Trial ―

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Influence of residual stenosis in determining restenosis after cutting balloon angioplasty

Cited by 11 publications

References 21 publications

Clinical and Angiographic Outcome after Cutting Balloon Angioplasty

Clinical and Angiographic Outcome after Cutting Balloon Angioplasty

Comparison of Cutting Balloon vs Stenting Alone in Small Branch Ostial Lesions of Native Coronary Arteries.

New Ultrasound-Controlled Paclitaxel Releasing Balloon vs. Asymmetric Drug-Eluting Stent in Primary ST-Segment Elevation Myocardial Infarction ― A Prospective Randomized Trial ―

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New Ultrasound-Controlled Paclitaxel Releasing Balloon vs. Asymmetric Drug-Eluting Stent in Primary ST-Segment Elevation Myocardial Infarction　― A Prospective Randomized Trial ―