Clinical Outcomes of Drug-Coated Balloons in Coronary Artery Disease Unsuitable for Drug-Eluting Stent Implantation

Iijima, Raisuke; Kougame, Norihiro; Hara, Hidehiko; Moroi, Masao; Nakamura, Masato

doi:10.1253/circj.cj-18-0121

Cited by 11 publications

(7 citation statements)

References 27 publications

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“…In all procedures, scoring balloon, Lacrosse NSE™ (Goodman Co., Ltd., Nagoya, Japan) or cutting balloon (Boston Scientific, Marlborough, MA, USA) was used for pre-dilatation under IVUS guidance. This was because previous studies have shown significantly lower incidences of major dissection in target lesions treated with the scoring balloon than with other devices, and the optimal lesion preparation using a scoring balloon is essential for ensuring a low incidence of target lesion failure after DCB treatment [14,15]. Further, appropriate lesion preparation was performed, after which, the lesion was dilated once for at least 30 s with the paclitaxel-coated (3 μg/mm 2 ) balloon catheter based on Paccocath Technology (SeQuent Please™, B. Braun Melsungen AG, Berlin, Germany) for drug delivery.…”

Section: Pci Proceduresmentioning

confidence: 99%

Possible mechanism of late lumen enlargement after treatment for de novo coronary lesions with drug-coated balloon

Yamamoto

Sawada

Uzu

et al. 2020

International Journal of Cardiology

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Background: Drug-coated balloon (DCB) treatment for de novo coronary artery disease has demonstrated late lumen enlargement (LLE) in mid-term follow-up and it was considered as clinical benefit; however, its mechanism and the predictive factor remains unclear. Methods: This study enrolled 46 consecutive patients (54 lesions) treated with DCB, using intravascular ultrasound (IVUS) at the index procedure and at the 9-month follow-up. We measured IVUS parameters at 1-mm intervals and calculated the mean volume of the external elastic membrane (EEM), lumen, and plaque. We calculated the dissection index (DI) defined as summation of the following points, 2: dissection over EEM, 1: intra-EEM dissection, 0: no dissection at every 1-mm interval, and divided by lesion length. Results: IVUS showed that there was no flow limiting dissection just after DCB treatment, the mean EEM and lumen volume (LV) had significantly increased while mean plaque volume had significantly decreased at 9 months, and 74.1% lesions exhibited LLE. We divided the patients into three groups according to delta mean LV. Mean EEM volume significantly increased and mean plaque volume significantly decreased in the larger and smaller LLE groups, but not in the non-LLE group. The DI was higher in a descending order in the three groups. The multiple regression analysis demonstrated that the DI was the strongest predictor of the change in mean LV. Conclusions: LLE after DCB treatment may be caused by vessel enlargement and plaque regression. The non-flow limiting larger dissection just after DCB treatment may strongly associate with the intending LLE.

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Section: Pci Proceduresmentioning

confidence: 99%

Possible mechanism of late lumen enlargement after treatment for de novo coronary lesions with drug-coated balloon

Yamamoto

Sawada

Uzu

et al. 2020

International Journal of Cardiology

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“…[5] In addition, the absence of a metallic stent and long-term polymer ensures the integrity of the vascular anatomy, which decreases hemodynamic abnormalities and shortens the duration of dual antiplatelet therapy. [6,7]…”

Section: Introductionmentioning

confidence: 99%

Drug-coated balloon versus drug-eluting stent in de novo small coronary vessel disease

Guo

et al. 2019

Medicine

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“…In addition, optimal lesion pretreatment is essential for the success of the DEB-only strategy. Iijima et al showed that the use of a nonslip element balloon was effective for optimal lesion preparation before the use of the DEB due to its ability to reduce elastic recoil, traumatic vessel injury, and dissection [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Comparisons of Drug-Eluting Balloon versus Drug-Eluting Stent in the Treatment of Young Patients with Acute Myocardial Infarction

Yang

et al. 2023

JCDD

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Background: The incidence of acute myocardial infarction (AMI) in the younger population has been increasing gradually in recent years. The objective of the present study is to investigate the safety and effectiveness of drug-eluting balloons (DEBs) in young patients with AMI. Methods: All consecutive patients with AMI aged ≤ 45 years were retrospectively enrolled. The primary endpoint was a device-oriented composite endpoint (DOCE) of cardiac death, target vessel myocardial infarction (MI), or target lesion revascularization (TLR). The secondary study endpoints included heart failure and major bleeding events. Results: A total of 276 young patients presenting with AMI were finally included. The median follow-up period was 1155 days. Patients treated with DEBs had a trend toward a lower incidence of DOCEs (3.0% vs. 11.0%, p = 0.12) mainly driven by the need for TLR (3.0% vs. 9.1%, p = 0.19) than those treated with DESs. No significant differences between the two groups were detected in the occurrence of cardiac death (0.0% vs. 0.5%, p = 0.69), MI (0.0% vs. 1.4%, p = 0.40), heart failure (0.0% vs. 1.9%, p = 0.39), or major bleeding events (1.5% vs 4.8%, p = 0.30). Multivariate regression analysis showed that DEBs were associated with a trend toward a lower risk of DOCEs (HR 0.13, 95% CI [0.02, 1.05], p = 0.06). Conclusions: The findings of the present study suggested that DEBs might be a potential treatment option in young patients with AMI. A larger scale, randomized, multicenter study is required to investigate the safety and effectiveness of DEBs in this setting.

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Clinical Outcomes of Drug-Coated Balloons in Coronary Artery Disease Unsuitable for Drug-Eluting Stent Implantation

Abstract: For lesions that are unsuitable for stent implantation, stent-less intervention using a DCB should be considered initially. The present study also highlighted that lesion preparation is key to a successful DCB strategy.

Cited by 11 publications

References 27 publications

Possible mechanism of late lumen enlargement after treatment for de novo coronary lesions with drug-coated balloon

Possible mechanism of late lumen enlargement after treatment for de novo coronary lesions with drug-coated balloon

Drug-coated balloon versus drug-eluting stent in de novo small coronary vessel disease

Comparisons of Drug-Eluting Balloon versus Drug-Eluting Stent in the Treatment of Young Patients with Acute Myocardial Infarction

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