Drug-Coated Balloon Versus Drug-Eluting Stent for Small Coronary Vessel Disease

Cortese, Bernardo; Guimaraes, Marcos García; Piraino, Davide; Orrego, Pedro Silva; Buccheri, Dario; Rivero, Fernando; Perotto, RN Anna; Zambelli, Giulia; Alfonso, Fernándo

doi:10.1016/j.jcin.2020.08.035

Cited by 98 publications

(83 citation statements)

References 25 publications

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“…Diabetes remained an independent predictor for TLF (HR: 2.712; CI: 1.254-5.864; P � 0.011) and TLR (HR: 3.698; CI: 1.112-12.298; P � 0.033) after adjustment. Our findings are in keeping with the previous studies that reported acceptable low rates of TLF and MACE with DCB in the small vessel [11,21,29,[31][32][33][34][35][36][37]. e PEPCAD I study reported 6.1% MACE events' rates after 12-month follow-up; the BASKET-SMALL 2 trial observed 7.5% MACE rates in the DCB arm [23,31].…”

Section: Discussionsupporting

confidence: 91%

Drug-Coated Balloon-Only Angioplasty Outcomes in Diabetic and Nondiabetic Patients with De Novo Small Coronary Vessels Disease

Benjamin

Liu

Han

et al. 2021

Journal of Interventional Cardiology

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Background. The revascularization of small vessels using drug-eluting stents remains challenging. The use of the drug-coated balloon is an attractive therapeutic strategy in de novo lesions in small coronary vessels, particularly in the diabetic group. This study aimed to assess the outcomes of DCB-only angioplasty in small vessel disease. Methods. A total of 1198 patients with small vessel disease treated with DCB-only strategy were followed. Patients were divided into the diabetic and nondiabetic groups. Clinical and angiographical follow-up were organized at 12 months. The primary endpoints were target lesion failure and secondary major adverse cardiac events. Results. There was a significantly higher rate of target lesion failure among diabetic patients compared to nondiabetic [17 (3.9%) vs. 11 (1.4%), P = 0.006 ], taken separately, the rate of target lesion revascularization significantly differed between groups with a higher rate observed in the diabetic group [9 (2%) vs. 4 (0.5%), P = 0.014 ]. Diabetes mellitus remained an independent predictor for TLF (HR: 2.712, CI: 1.254–5.864, P = 0.011 ) and target lesion revascularization (HR: 3.698, CI: 1.112–12.298, P = 0.033 ) after adjustment. However, no significant differences were observed between groups regarding the target vessel myocardial infarction (0.6% vs. 0.1%, P = 0.110 ) and MACE [19 (4.4%) vs. 21 (2.7%), P = 0.120 ]. Conclusion. Drug-coated balloon-only treatment achieved lower incidence rates of TLF and MACE. Diabetes is an independent predictor for target lesion failure and target lesion revascularization at one year following DCB treatment in small coronary vessels. We observed no significant differences between groups regarding MACE in one year.

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Section: Discussionsupporting

confidence: 91%

Drug-Coated Balloon-Only Angioplasty Outcomes in Diabetic and Nondiabetic Patients with De Novo Small Coronary Vessels Disease

Benjamin

Liu

Han

et al. 2021

Journal of Interventional Cardiology

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“… 22 More recently, in PICCOLETO 2 trial we compared Xience DES and Elutax SV, demonstrating superior late lumen loss with the latter (0.04 vs. 0.17 mm, P = 0.001) and no difference in MACE at 12 months (5.6% vs. 7.5%, P = 0.55). 9 …”

Section: Drug-coated Balloon Overviewmentioning

confidence: 99%

“…7 Conversely, drug-coated balloons (DCB) are an emerging technology which nowadays in 2021 should aim at significantly decrease the use of stents in such complex scenarios, thanks to the fact that they have demonstrated to be easy to use, safe and with good clinical outcome in some groups of patients with CAD. 8 , 9 …”

Section: Introductionmentioning

confidence: 99%

Back to the future: DCB use instead of DES for the treatment of complex, native coronary artery disease

Cortese

Sanchez-Jimenez

2021

European Heart Journal Supplements

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The increasing complexity of coronary artery lesions in patients with significant co-morbidities and the need for revascularization, but with the ineligibility for surgical approach, has turned the percutaneous coronary intervention a challenging task, especially in a setting in which short- and long-term complications after drug-eluting stent implantation are high. Drug-coated balloons (DCBs) have become an important tool to replace stent placement in specific situations such as small coronary artery disease and in-stent restenosis. Although preliminary data of DCB use in complex lesions is promising, the available data are still limited. Therefore, in this article, we review the most recent and relevant literature about the use of DCB in native vessel disease and in complex anatomies/patients, and pretend to justify the necessity to develop well design trials about the use of this therapy in such settings, also thinking at DCBs as a complementary tool to drug-eluting stents.

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“…However, DCB were associated with a lower incidence of MI (RR 0.48, 95% CI 0.25-0.90) and allcause mortality (RR 0.45, 95% CI 0.22-0.94). Finally, the PICCOLETO II RCT recently compared DCB with everolimus-DES in 118 stable patients with de novo lesions in small vessels [74]. At 6 months, in-lesion late lumen loss (primary endpoint) was 0.17±0.39 mm in the everolimus-DES group and 0.04±0.28 mm in the DCB group, meeting the predefined non-inferiority criteria (P=0.03).…”

Section: Interventional Devicesmentioning

confidence: 99%

Acute and one-year clinical outcomes of pre-stenting intravascular ultrasound: a patient-level meta-analysis of randomised clinical trials

Hong¹,

Kim²,

Kim³

et al. 2021

EuroIntervention

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Drug-Coated Balloon Versus Drug-Eluting Stent for Small Coronary Vessel Disease

Cited by 98 publications

References 25 publications

Drug-Coated Balloon-Only Angioplasty Outcomes in Diabetic and Nondiabetic Patients with De Novo Small Coronary Vessels Disease

Drug-Coated Balloon-Only Angioplasty Outcomes in Diabetic and Nondiabetic Patients with De Novo Small Coronary Vessels Disease

Back to the future: DCB use instead of DES for the treatment of complex, native coronary artery disease

Acute and one-year clinical outcomes of pre-stenting intravascular ultrasound: a patient-level meta-analysis of randomised clinical trials

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