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Characteristics and Outcomes of Patients Undergoing Drug-coated Balloon Angioplasty: The Initial 4-year Experience in
Rasha Kaddoura1, Jassim Z Shah2, Mohamed Izham Mohamed Ibrahim3
1Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
Insights
Drug-coated balloons (DCB) offer an alternative to drug-eluting stents (DES) for in-stent restenosis (ISR). Initial findings show comparable patient and clinical outcomes between DCB and DES for ISR treatment.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Medical Devices
Background:
- Drug-coated balloons (DCB) provide a stentless treatment option for coronary artery lesions.
- International guidelines endorse DCB for in-stent restenosis (ISR).
- The clinical utility of DCB beyond ISR requires further investigation.
Purpose of the Study:
- To report the initial four-year experience with DCB angioplasty at an institution.
- To compare patient and clinical outcomes of DCB versus drug-eluting stents (DES) for ISR.
Main Methods:
- A single-center retrospective study was conducted.
- Data from patients treated with DCB or DES for ISR between January 2018 and November 2021 were analyzed.
- 572 patients (132 DCB, 440 DES) were included.
Main Results:
- No significant differences were observed in demographics, comorbidities, or angiographic characteristics between DCB and DES groups.
- Clinical outcomes were also comparable between the two treatment groups.
- In the DCB group, 9.8% of patients presented with acute coronary syndrome (ACS) and chest pain, with a median time to first event of 480 days.
Conclusions:
- DCB use is growing in Qatar, initially focused on ISR.
- DCB demonstrated similar patient, angiographic, and clinical outcomes compared to DES for ISR.
- Further research is warranted to explore DCB applications in broader indications.
Background:
A drug-coated balloon (DCB) allows treating the coronary artery lesions without permanent implantation of a metallic stent. International guidelines recommend DCB for the treatment of in-stent restenosis (ISR). Although DCB showed promising results in treating ISR, their role is still not well established in the broader clinical practice.
Objective:
In this short report, we describe our institution's four-year initial experience in using DCB angioplasty, and compare the characteristics and outcomes of the patients treated with DCB with those treated with drug-eluting stent (DES) for ISR.
Methods:
This is a single-center retrospective study of patients who underwent coronary angioplasty with either DCB or DES from January 1, 2018 to November 30, 2021 at the Heart Hospital in the State of Qatar.
Results:
A total of 572 patients with ISR were recruited, 132 and 440 patients were in the DCB and DES group, respectively. In the DCB group, the median age was 57.9 years and there were 117 (88.6%). There was no significant difference between the DCB and DES groups in term demographics, comorbidities, coronary angiography indication or characteristics, and clinical outcomes. With regards the clinical outcomes, 13 patients (9.8%) underwent angioplasty for ACS and chest pain in the DCB group. The median time to the first event was a median of 480 days (16 months).
Conclusion:
The use of DCB is increasing in Qatar. The initial experience was limited to its use in ISR. Patient characteristics, angiographic characteristics, and clinical outcomes in the DCB group did not significantly differ from those in the DES group. More studies are needed to evaluate the use of DCB in wider indications.
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