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Drug eluting balloon: a multipurpose tool for coronary revascularization with optimal long-term follow-up results
Luigi Emilio Pastormerlo1, Marco Ciardetti, Giuseppe Trianni
1Division of Interventional Cardiology, Fondazione G. Monasterio CNR-Regione Toscana, Pisa-Massa, Italy.
Insights
Drug-coated balloons (DCB) demonstrate excellent long-term safety and efficacy in real-world patients undergoing percutaneous coronary revascularization for diverse conditions. This study confirms DCB as a valuable tool with a low complication rate.
Area of Science:
- Cardiovascular Interventions
- Interventional Cardiology
- Medical Device Technology
Background:
- Drug-coated balloons (DCB) offer a promising alternative for percutaneous coronary revascularization.
- Evaluating the long-term safety and efficacy of DCB in a broad patient population is crucial.
Purpose of the Study:
- To assess the long-term outcomes of DCB use in a large cohort of real-world patients.
- To evaluate the safety and efficacy of DCB across various clinical and angiographic scenarios.
Main Methods:
- A real-world series of 110 patients undergoing percutaneous revascularization with paclitaxel-eluting balloons (Sequent Please).
- Assessment of major adverse cardiac events (MACE), including all-cause death, myocardial infarction (MI), target vessel revascularization (TVR), and target lesion revascularization (TLR).
- Follow-up duration was a median of 23 months.
Main Results:
- The cumulative MACE rate was 12.7% at long-term follow-up.
- All-cause death occurred in 8.2% of patients, with one fatal MI.
- Target vessel revascularization (TVR) and target lesion revascularization (TLR) rates were 4.5% and 3.6%, respectively, with no reported vessel thrombosis.
Conclusions:
- Drug-coated balloons (DCB) are highly effective for a wide range of clinical and angiographic indications.
- DCB demonstrate a low rate of complications and favorable long-term results in clinical practice.
- DCB represent a valuable therapeutic option for complex coronary interventions.
Aims:
This study aimed to evaluate safety and efficacy of drug-coated balloon (DCB) at long-term follow-up; a large series of real-life patients underwent revascularization with DCB for a wide spectrum of clinical and angiographic situations.
Methods And Results:
One hundred ten patients underwent percutaneous revascularization using paclitaxel eluting balloon (Sequent Please, Braun, Germany). End-points were major adverse cardiac events (MACE; all-cause death, myocardial infarction [MI], target vessel revascularisation [TVR], and vessel thrombosis). DCB were used for stable angina (58%), unstable angina/nonST elevation MI (31%) and ST elevation MI (11%). DCB were used for in-stent restenosis (61%), small vessel disease (25%), with bare metal stent (BMS) to avoid long dual antiplatelet therapy (10%) or for impossibility to place a stent (4%). Cumulative MACE at follow-up (median 23 months, IQR 13-32) was 12.7%, with 8.2% all-cause death (1 fatal MI), 4.5% TVR, 3.6% TLR, and no vessel thrombosis. Three of four TLRs occurred in patients who received DEB for DES restenosis.
Conclusions:
DCB are a very effective tool for a variety of clinical and angiographic situations. DCB use seems to be affected by a low rate of complications and adequate results at long-term follow-up.
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