Major adverse cardiac events and drug-coated balloon size in coronary interventions

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Biomaterials Science

Background:

• In-stent restenosis (ISR) is a significant complication following coronary stent placement.
• Drug-coated balloons (DCBs) are increasingly used to treat ISR, delivering anti-proliferative drugs to the vessel wall.
• The optimal length of DCBs for ISR treatment and its impact on clinical outcomes remain under investigation.

Purpose of the Study:

• To investigate the association between drug-coated balloon (DCB) length and clinical outcomes in patients treated for in-stent restenosis (ISR).
• To compare the benefit-risk ratio of using 15-mm versus 20-mm DCBs for ISR treatment.

Main Methods:

• A retrospective analysis of 286 patients treated with Pantera Lux (Paclitaxel-eluting) DCBs for ISR between 2009 and 2012.
• Patients were divided into two groups based on DCB length: 15-mm (n=176) and 20-mm (n=109).
• Major adverse cardiac events (MACE), including death, myocardial infarction, and target lesion revascularization, were assessed during hospitalization and at a 2-year follow-up.

Main Results:

• Baseline patient characteristics and cardiovascular risk factors were similar between the 15-mm and 20-mm DCB groups.
• In-hospital MACE rates were comparable: 1.7% for 15-mm DCB versus 2.8% for 20-mm DCB (p=0.554).
• At 2-year follow-up, MACE rates also showed no significant difference: 23.2% for 15-mm DCB versus 27.5% for 20-mm DCB (p=0.408).

Conclusions:

• Drug-coated balloon length was not found to be associated with clinical outcomes in patients treated for in-stent restenosis.
• Neither 15-mm nor 20-mm DCBs demonstrated a significant difference in MACE at 2-year follow-up.
• The findings suggest that DCB length may not be a critical factor influencing the long-term efficacy and safety of ISR treatment.