Percutaneous coronary intervention with drug‐coated balloon‐only strategy in stable coronary artery disease and in acute coronary syndromes: An all‐comers registry study

Uskela, Sanna; Kärkkäinen, Jussi M.; Eränen, Jaakko; Siljander, Antti; Mäntylä, Pirjo; Mustonen, Juha; Rissanen, Tuomas T.

doi:10.1002/ccd.27950

Cited by 40 publications

(30 citation statements)

References 31 publications

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“…1G). The DCB is efficacious in de-novo coronary artery lesions [1], which mainly contributed to suppress the restenosis in this case; however, although OFDI after ELCA demonstrated a slight increase in MLA, ELCA might be attributed to the lesion debulking and modification leading to optimal balloon expansion. A similar mechanism was previously reported in the case of in-stent restenosis [2].…”

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confidence: 61%

A case of a de-novo lesion in the left circumflex artery treated with excimer laser and drug-coated balloon under the guidance of optical frequency domain imaging

et al. 2019

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A 72-year-old man who previously underwent percutaneous coronary intervention with a drugeluting stent implantation from the left main trunk and extending to proximal left anterior descending artery was admitted to the documented hospital for angina pectoris. Coronary angiography (CAG) revealed 90% stenosis at the ostium of the left circumflex artery (LCX) (Fig. 1A). Excimer laser coronary angioplasty (ELCA) was performed using a 0.9 mm concentric laser catheter at a pulse rate of 25 Hz and energy output of 45 mJ/mm 2 , 35 Hz and 55 mJ/mm 2 , and 45 Hz and 60 mJ/mm 2 for a total of 5200 pulses and balloon angioplasty using a drugcoated balloon (DCB) under the guidance of optical frequency domain imaging (OFDI), which revealed fibrous plaque and eccentric severe calcification ( Fig. 1B). After ELCA, minimum lumen area (MLA) increased from 1.4 mm 2 to 2.6 mm 2 (Fig. 1C) and on final OFDI to 3.9 mm 2 along with minor plaque dissection ( Fig. 1D). Final CAG demonstrated optimal result without flow limitation ( Fig 1E). After discharge, no significant clinical events were reported. Eight months later, follow-up CAG and OFDI were performed. Follow-up CAG demonstrated no restenosis at the ostium of the LCX (Fig. 1F). OFDI showed that the MLA slightly decreased from 3.9 mm 2 to 3.5 mm 2 and that the minor dissection had clearly improved (Fig. 1G). The DCB is efficacious in de-novo coronary artery lesions [1], which mainly contributed to suppress the restenosis in this case; however, although OFDI after ELCA demonstrated a slight increase in MLA, ELCA might be attributed to the lesion debulking and modification leading to optimal balloon expansion. A similar mechanism was previously reported in the case of in-stent restenosis [2]. For acute myocardial infarction, the combined use of ELCA and DCB for de-novo coronary artery disease works synergistically to reduce restenosis [3]. Stent-less strategy employing ELCA and DCB may be an effective revascularization of large vessel denovo lesions, when traditional stent deployment is not a viable option.Informed consent was obtained from the patient in accordance with the Helsinki Declaration. AcknowledgementsThe authors wish to thank Dr. Richard H. Kaszynski for reviewing and revising this manuscript.

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A case of a de-novo lesion in the left circumflex artery treated with excimer laser and drug-coated balloon under the guidance of optical frequency domain imaging

et al. 2019

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“…Indeed, the reported cohort included patients with relevant vessel diameter (56.5% of the patients with vessel diameter ≥3 mm), high plaque complexity (Ellis C classification in 48.2% of the lesions), and left main involvement (13 patients). This retrospective study could be seen as a first small “proof of concept” of the potential marginal role of DAPT after a successful DCB angioplasty, opening the door to an even shorter DAPT strategy, or directly to a no‐DAPT strategy as reported in a small number of patients in a recent study 4 …”

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confidence: 79%

Drug‐coated balloon angioplasty and 1 month DAPT strategy: Insights from the real world

Musumeci

Albani

2020

Cathet Cardio Intervent

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“…The DEBUT trial (de-novo coronary artery lesions in patients with high bleeding risk) includes a larger diameter of coronary arteries lesions (2.5-4 mm) patient in the trial and only 1% MACE incidence at 9 months follow-up compared with 14% in the bare metal stent group (risk ratio 0.07 [95% CI 0.01 to 0.52]) [32]. In another single-center study in which 60% of the patients with lesions in more than 3 mm coronary vessels and de novo lesions including large proximal coronary arteries are managed by DEB, it shows a 7.1% MACE rate in stable coronary artery diseases and 12% in acute coronary syndrome [33].…”

Section: Drug-eluting Balloon (Deb) Vs Stent-based Pcimentioning

confidence: 99%

Drug-eluting balloon: is it useful?

Laksono¹,

Setianto

Surya³

2020

Egypt Heart J

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Background Coronary artery disease is one of the major issues in the medical world around the globe. The prevalence tends to increase. The use of coronary intervention is one of the ways often used in the management of coronary artery disease due to its satisfying result from earlier studies. Nowadays, there are several different techniques in coronary intervention: balloon vs stent. Main body The stent-based vascular interventions are increasingly being used over balloon-based coronary intervention. However, revascularization intervention using stent often have undesirable long-term effects compared to balloon. Besides, stent-based interventions are also considered more expensive, use more complicated techniques, and use more drug regimens. On the other hand, percutaneous coronary intervention techniques using balloons coated by anti-proliferation drugs have begun to be glimpsed by many interventionists. Studies have found many benefits that cannot be given by stent-based intervention therapy. Conclusions Angioplasty using percutaneous coronary intervention techniques reveals satisfying result compared to conservative medical treatment. The indication and technique of percutaneous coronary intervention is still evolving until now. Currently, percutaneous coronary intervention using stent, either bare-metal stent or drug-eluting stent, is preferred by interventionist. Nevertheless, recent clinical trial favors the using of drug-eluting balloon for percutaneous coronary intervention in terms of both clinical outcome and complication in several scenarios.

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Percutaneous coronary intervention with drug‐coated balloon‐only strategy in stable coronary artery disease and in acute coronary syndromes: An all‐comers registry study

Cited by 40 publications

References 31 publications

A case of a de-novo lesion in the left circumflex artery treated with excimer laser and drug-coated balloon under the guidance of optical frequency domain imaging

A case of a de-novo lesion in the left circumflex artery treated with excimer laser and drug-coated balloon under the guidance of optical frequency domain imaging

Drug‐coated balloon angioplasty and 1 month DAPT strategy: Insights from the real world

Drug-eluting balloon: is it useful?

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