The role of drug-coated balloons for coronary bifurcation management: results from the prospective EASTBOURNE-BIF...

Area of Science:

• Interventional Cardiology
• Vascular Medicine
• Biomedical Engineering

Background:

• Coronary bifurcation lesions present a higher risk compared to other lesion types.
• Previous small studies suggested promising outcomes for drug-coated balloons (DCB) in treating these lesions.
• The EASTBOURNE-BIF prospective registry investigated the use of a sirolimus-eluting DCB for bifurcation lesions.

Purpose of the Study:

• To evaluate the safety and efficacy of sirolimus-eluting DCB in treating coronary bifurcation lesions.
• To compare outcomes of DCB treatment for bifurcation lesions against de-novo lesions.
• To assess the role of DCB, alone or in combination with drug-eluting stents, for bifurcation treatment.

Main Methods:

• A prospective registry (EASTBOURNE-BIF) included 194 patients with bifurcation lesions (Medina classification).
• Outcomes were compared to 1049 patients with de-novo lesions from the same registry.
• Treatment strategies included a blended approach (stent in main branch, DCB in side branch) and a full-DCB approach.

Main Results:

• One-year follow-up showed similar target-lesion revascularization rates between bifurcation and de-novo groups (4.2% vs. 2%, P=0.28).
• Comparable rates were observed for all-cause death (3.3% vs. 1.4%, P=0.138) and major adverse cardiovascular events (8.8% vs. 5.2%, P=0.081).
• Spontaneous myocardial infarction rates were also similar (2.8% vs. 1.0%, P=0.117).

Conclusions:

• Sirolimus-eluting DCB, used alone or with drug-eluting stents, offers a safe and effective alternative for treating coronary bifurcation lesions.
• The findings support the use of DCB as a viable option in interventional cardiology for complex bifurcation interventions.
• The EASTBOURNE-BIF registry provides robust data on DCB performance in a real-world bifurcation lesion setting.