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Drug-eluting balloon: is it useful?
Sidhi Laksono1,2, Budhi Setianto3, Steven Philip Surya4
1Cardiac Catheterization Laboratory, Department of Cardiology and Vascular Medicine, RSUD Pasar Rebo, Jakarta, Indonesia. sidhilaksono@uhamka.ac.id.
Insights
Drug-eluting balloons offer a promising alternative to traditional stents for coronary artery interventions, showing favorable clinical outcomes and fewer complications in certain scenarios. This approach advances coronary artery disease management.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- Coronary artery disease (CAD) is a growing global health concern.
- Coronary interventions, particularly stenting, are common treatments for CAD.
- Existing interventions face challenges including long-term effects and cost.
Purpose of the Study:
- To compare the efficacy and safety of balloon-based versus stent-based coronary interventions.
- To evaluate the emerging role of drug-eluting balloons (DEBs) in percutaneous coronary intervention (PCI).
Main Methods:
- Review of clinical trials comparing balloon angioplasty with stenting in CAD.
- Analysis of outcomes associated with drug-eluting balloons versus drug-eluting stents.
- Assessment of factors such as clinical outcomes, complications, cost, and technique complexity.
Main Results:
- Stent-based interventions, while prevalent, are associated with potential long-term adverse effects.
- Drug-eluting balloons demonstrate significant benefits not achievable with traditional stent therapy.
- PCI using DEBs shows advantages in clinical outcomes and complication profiles in specific patient groups.
Conclusions:
- Percutaneous coronary intervention (PCI) provides effective treatment for coronary artery disease compared to medical management.
- While stents (bare-metal and drug-eluting) are currently preferred, drug-eluting balloons are emerging as a favorable option.
- Recent clinical trials suggest drug-eluting balloons offer superior clinical outcomes and reduced complications in select PCI scenarios.
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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