Preliminary experience with drug-coated balloon angioplasty in primary percutaneous coronary intervention

Abstract

We evaluated the clinical feasibility of using drug-coated balloon (DCB) angioplasty in patients undergoing primary percutaneous coronary intervention (PPCI). Between January 2010 to September 2014, 89 ST-elevation myocardial infarction patients (83% male, mean age 59 ± 14 years) with a total of 89 coronary lesions were treated with DCB during PPCI. Clinical outcomes are reported at 30 d follow-up. Left anterior descending artery was the most common target vessel for PCI (37%). Twenty-eight percent of the patients had underlying diabetes mellitus. Mean left ventricular ejection fraction was 44% ± 11%. DCB-only PCI was the predominant approach (96%) with the remaining 4% of patients receiving bail-out stenting. Thrombolysis in Myocardial Infarction (TIMI) 3 flow was successfully restored in 98% of patients. An average of 1.2 ± 0.5 DCB were used per patient, with mean DCB diameter of 2.6 ± 0.5 mm and average length of 23.2 ± 10.2 mm. At 30-d follow-up, there were 4 deaths (4.5%). No patients experienced abrupt closure of the infarct-related artery and there was no reported target-lesion failure. Our preliminary experience showed that DCB angioplasty in PPCI was feasible and associated with a high rate of TIMI 3 flow and low 30-d ischaemic event.

Drug-Eluting Balloons in the Treatment of Coronary De Novo Lesions: A Comprehensive Review

“…These findings were supported by Ho et al using the SeQuent Please DEB in the treatment of 89 patients presenting with STEMI [73]. Thrombus aspiration was performed in 56% and predilatation in 100% of patients before DEB treatment, which yielded a low 4% bailout rate.…”

Drug‐Coated Balloons: A Safe and Effective Alternative to Drug‐Eluting Stents in Small Vessel Coronary Artery Disease

“…Predilatation was done on a 1:1 balloon to artery ratio basis and the decision to treat with DCB was only made after initial predilatation. Our previous published study on DCB angioplasty revealed only 4% of the patients required bailout stenting for significant recoil/dissection (>type B dissection) …”

“…5 Drug-coated balloons (DCB) have recently emerged as a potential therapeutic strategy for patients with small vessel de novo coronary artery disease, 6,7 even in the setting of primary angioplasty. 8 DCB allow rapid and uniform tissue delivery of paclitaxel to the lesion of interest and is an established treatment modality for in-stent restenosis. 9 In de novo disease, a DCB strategy allows stent-free revascularization, thereby removing the detrimental effect of metal from the equation that drives LLL.…”

Drug-Coated Balloons in STEMI

“…DCBonly PCI was carried out in 96%, while the other 4% had bail out stenting for significant acute recoil or dissections. They reported a death rate of 4.5%, MI 0%, and TLR/TVR of 0% at 30 days [19].…”