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Updated: Apr 8, 2026
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
Preliminary experience with drug-coated balloon angioplasty in primary percutaneous coronary intervention
Hee Hwa Ho1, Julian Tan1, Yau Wei Ooi1
1Hee Hwa Ho, Julian Tan, Yau Wei Ooi, Kwok Kong Loh, Than Htike Aung, Nwe Tun Yin, Dasdo Antonius Sinaga, Fahim Haider Jafary, Paul Jau Lueng Ong, Department of Cardiology, Tan Tock Seng Hospital, 308433 Singapore, Singapore.
Insights
Drug-coated balloon (DCB) angioplasty is a feasible treatment for ST-elevation myocardial infarction patients during primary percutaneous coronary intervention (PPCI). This approach demonstrated high rates of restored blood flow and low short-term adverse events.
Area of Science:
- Interventional Cardiology
- Cardiovascular Medicine
Background:
- Primary percutaneous coronary intervention (PPCI) is the standard treatment for ST-elevation myocardial infarction (STEMI).
- Drug-coated balloons (DCB) offer a potential alternative to stenting in certain coronary interventions.
Purpose of the Study:
- To assess the clinical feasibility and early outcomes of DCB angioplasty in patients undergoing PPCI for STEMI.
- To evaluate the safety and efficacy of DCB use in the acute setting of myocardial infarction.
Main Methods:
- Retrospective analysis of 89 STEMI patients treated with DCB during PPCI between January 2010 and September 2014.
- DCB-only angioplasty was the primary strategy, with bail-out stenting in a small percentage of cases.
- Clinical outcomes were assessed at 30-day follow-up.
Main Results:
- Successful restoration of Thrombolysis in Myocardial Infarction (TIMI) 3 flow in 98% of patients.
- A low 30-day mortality rate of 4.5% was observed.
- No instances of abrupt vessel closure or target-lesion failure were reported.
Conclusions:
- DCB angioplasty is clinically feasible in the context of PPCI for STEMI.
- The procedure is associated with high rates of successful reperfusion and favorable early safety outcomes.
- DCB angioplasty represents a promising option for selected STEMI patients, potentially reducing the need for metallic stents.
Abstract:
We evaluated the clinical feasibility of using drug-coated balloon (DCB) angioplasty in patients undergoing primary percutaneous coronary intervention (PPCI). Between January 2010 to September 2014, 89 ST-elevation myocardial infarction patients (83% male, mean age 59 ± 14 years) with a total of 89 coronary lesions were treated with DCB during PPCI. Clinical outcomes are reported at 30 d follow-up. Left anterior descending artery was the most common target vessel for PCI (37%). Twenty-eight percent of the patients had underlying diabetes mellitus. Mean left ventricular ejection fraction was 44% ± 11%. DCB-only PCI was the predominant approach (96%) with the remaining 4% of patients receiving bail-out stenting. Thrombolysis in Myocardial Infarction (TIMI) 3 flow was successfully restored in 98% of patients. An average of 1.2 ± 0.5 DCB were used per patient, with mean DCB diameter of 2.6 ± 0.5 mm and average length of 23.2 ± 10.2 mm. At 30-d follow-up, there were 4 deaths (4.5%). No patients experienced abrupt closure of the infarct-related artery and there was no reported target-lesion failure. Our preliminary experience showed that DCB angioplasty in PPCI was feasible and associated with a high rate of TIMI 3 flow and low 30-d ischaemic event.
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