Six month angiographic result of supplementary paclitaxel-eluting balloon deployment to treat side branch ostium narrowing (SARPEDON)

Jim, Man‐Hong; Lee, Michael Kang-Yin; Fung, Raymond Chi-yan; Chan, Alan Ka Chun; Chan, Kin; Yiu, Kai‐Hang

doi:10.1016/j.ijcard.2015.04.002

Cited by 20 publications

(11 citation statements)

References 17 publications

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“…e reason is to avoid the difficulty of DCB passing through the stent mesh as well as to reduce the damage of the surface coating and the loss of the delivered drug during the process of DCB passing through the stent mesh. However, consistent with Jim's report [10], in this study, most patients had undergone different surgical procedures, and during the 1-year follow-up, no significant adverse effects on the prognosis were observed. is may be related to adequate SB pretreatment.…”

Section: Discussionsupporting

confidence: 92%

“…In recent years, the application of drug-coated balloons (DCBs) in coronary bifurcation lesions has attracted widespread attention, and the use of combined main branch (MB) DES implantation and SB DCB dilation as a new treatment strategy is expanding. A number of clinical studies have shown that DES plus DCB is a safe and effective strategy for the treatment of coronary artery bifurcation lesions because it can effectively reduce the use of additional stents in SB and has less late lumen loss (LLL) in SB during angiographic follow-up [9][10][11]. However, these studies included fewer lesions in the left main bifurcation and lacked a comparison with the traditional double-stent strategy.…”

Section: Introductionmentioning

confidence: 99%

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Improved Outcomes of Combined Main Branch Stenting and Side Branch Drug-Coated Balloon versus Two-Stent Strategy in Patients with Left Main Bifurcation Lesions

Liu

Tao

Han

et al. 2022

Journal of Interventional Cardiology

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Background. Drug-eluting stent (DES) plus drug-coated balloon (DCB) is a safe and effective treatment strategy for coronary artery bifurcation lesions, but there is no report about this strategy being used for left main (LM) bifurcation lesions. We aim to explore the efficacy and safety of DES plus DCB in the treatment of LM bifurcation lesions. Methods. A total of 100 patients diagnosed with LM bifurcation lesions by coronary angiography were retrospectively enrolled at our center from January 2018 to December 2019. They received either a two-stent strategy or a main branch (MB) stenting plus side branch (SB) DCB strategy and were accordingly divided into the 2-DES group and the DES + DCB group. Patients treated with DES + DCB were compared with a cohort of matched patients treated with a 2-DES strategy. Clinical data was collected and quantitative coronary analysis was performed. Results. For immediate postoperative angiography, though the two groups had no differences in the minimal luminal diameter (MLD) and luminal stenosis of MB, the DES + DCB group had significantly lower SB ostial MLD and a higher degree of residual lumen stenosis than the 2-DES group ( P < 0.05 ). At the time of follow-up, the SB ostial MLD of the DES + DCB group was higher than that of the 2-DES group, but lumen stenosis, late lumen loss (LLL), and LLL at the distal end of the left MB were all smaller than those of the 2-DES group ( P s < 0.05 ). Furthermore, the incidence of lumen restenosis and MACE between the two groups had no significance. Conclusion. The combination of DES and DCB is relatively safe and effective for the treatment of LM bifurcation lesions, and this strategy seems to have advantages in reducing LLL at the SB ostium.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Improved Outcomes of Combined Main Branch Stenting and Side Branch Drug-Coated Balloon versus Two-Stent Strategy in Patients with Left Main Bifurcation Lesions

Liu

Tao

Han

et al. 2022

Journal of Interventional Cardiology

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“…Following a 9-month follow-up, the MACE, TLR, and LLL were all low, and 11 of the 35 lesions were identified by core lab analysis to be true bifurcation lesions. The SARPEDON study ( 10 ) evaluated the effectiveness of treating the SB ostium with DCB following DES implantation in MV, followed by the kissing balloon technique. At 1-year of follow-up, the MACE rate was 19.0%, with three target vessel revascularization and two all-cause death.…”

Section: Discussionmentioning

confidence: 99%

“…DCB has well-established efficacy in treating coronary in-stent restenosis (ISR) ( 5 , 6 ) and de novo lesions ( 7 – 9 ). Notably, the past decade has witnessed significant inroads achieved in DCB technology, lesion preparation, and clinical experience for bifurcation PCI ( 10 – 12 ).…”

Section: Introductionmentioning

confidence: 99%

Drug-coated balloon in the treatment of coronary left main true bifurcation lesion: A patient-level propensity-matched analysis

Pan

Liu

Han

et al. 2022

Front. Cardiovasc. Med.

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AimsAn increasing body of evidence suggests that drug-coated balloon (DCB) angioplasty represents a valuable option for revascularization in selected patients with coronary bifurcation disease. However, there remains a paucity of real-world observational evidence on the efficacy of DCB in left main (LM) true bifurcation lesion. We compared clinical and angiographic outcomes of hybrid [DCB + drug-eluting stent (DES)] versus DES-only strategy (provisional stenting or two-stent strategies) in de novo LM true bifurcated lesions.MethodsThe primary endpoint was the 2-year composite rate of target lesion failure (TLF): cardiac death, target vessel myocardial infarction (TVMI), or clinically driven target lesion revascularization (CD-TLR). A routine 1-year angiographic follow-up was scheduled. Propensity-score matching was utilized to assemble a cohort of patients with similar baseline characteristics.ResultsAmong 1077 eligible patients, 199 who received DCB treatment and 398 who were assigned to DES therapy had similar propensity scores and were included in the analysis. TLF within 2 years occurred in 13 patients (7.56%) assigned to DCB group, and 52 patients (14.36%) assigned to DES group (odds ratio: 0.487; 95% confidence interval: 0.258–0.922; P = 0.025; Log-rank P = 0.024). Compared with the DES group, the DCB group resulted in a lower rate of CD-TLR (2.91% vs. 9.42%; P = 0.007). Cardiac death, TVMI, all-cause mortality, and stent thrombosis were comparable between both groups. Patients treated with DES-only were associated with a higher late lumen loss (0.42 ± 0.62 mm vs. 0.13 ± 0.42 mm, P < 0.001) compared with the DCB group at 1 year. In sensitivity analysis, the DCB group also presented a lower incidence of TLF, CD-TLR and stent thrombosis both compared to the two-stent strategy and compared to provisional stenting (Ps < 0.05).ConclusionThe 2-year results of PCI utilizing DCB for LM true bifurcation lesions are superior to employing DES alone in terms of safety and effectiveness.

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“…32 Similar results were found in the SARPEDON study which assessed the efficacy of DCB at the SB ostium after DES implantation in the MB, with good angiographic outcome and low rate of restenosis, although a high rate of MACE (19% at 1 year). 33 Finally, the PEPCAD-BIF multicentre trial was published in 2016, which enrolled 64 patients with a bifurcation lesion and randomised them to DCB versus POBA after MB stenting. Only 5 patients underwent stenting in the SB as a bail-out strategy.…”

Section: Drug-coated Balloons In Bifurcation Lesionsmentioning

confidence: 99%

Drug-Coated Balloons and Coronary Bifurcation Lesions

Durante

Laforgia

2017

EMJ Int Cardiol

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Bifurcation coronary lesions still represent a challenge for interventional cardiologists. Although provisional stenting is considered the gold standard for the treatment of bifurcations, some studies report good results with two-stent techniques. In the last few years, drug-coated balloons have been used for the treatment of several kinds of coronary lesion, such as in-stent restenosis, small vessels, and bifurcations. The use of drug coated balloons for the treatment of the side branch after provisional stenting is a promising option for further improving provisional stenting results.

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Six month angiographic result of supplementary paclitaxel-eluting balloon deployment to treat side branch ostium narrowing (SARPEDON)

Cited by 20 publications

References 17 publications

Improved Outcomes of Combined Main Branch Stenting and Side Branch Drug-Coated Balloon versus Two-Stent Strategy in Patients with Left Main Bifurcation Lesions

Improved Outcomes of Combined Main Branch Stenting and Side Branch Drug-Coated Balloon versus Two-Stent Strategy in Patients with Left Main Bifurcation Lesions

Drug-coated balloon in the treatment of coronary left main true bifurcation lesion: A patient-level propensity-matched analysis

Drug-Coated Balloons and Coronary Bifurcation Lesions

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