The role of drug-eluting balloons alone or in combination with drug-eluting stents in the treatment of de novo diffuse coronary disease.

Abstract

OBJECTIVES:

This study sought to investigate the role of drug-eluting balloons (DEB) alone or in combination with drug-eluting stents (DES) in the treatment of diffuse de novo coronary artery disease (CAD) (>25 mm).

BACKGROUND:

The use of DEB in diffuse CAD, either alone or in combination with DES, offers an alternative to stenting alone. Data regarding DEB in this context are limited.

METHODS:

We retrospectively evaluated all patients treated with DEB for diffuse CAD between June 2009 and October 2012. Endpoints analyzed were major adverse cardiac events, defined as all-cause death, myocardial infarction, and target vessel revascularization (TVR), as well as TVR and target lesion revascularization separately. Results were compared with those obtained from a cohort of patients with similar characteristics treated with DES alone.

RESULTS:

A total of 69 patients (93 lesions) were treated with DEB ± DES, and 93 patients with DES alone (93 lesions). A high proportion of patients were diabetic (46.4% vs. 44.1%, p = 0.77). Of the DEB-treated lesions, 56.0% were treated with DEB alone, 7.4% with DEB and DES as bail out, and 36.6% with DES and DEB as part of a hybrid approach for very long disease. Outcome rates with DEB ± DES were comparable to those with DES alone at 2-year follow-up (major adverse cardiac events = 20.8% vs. 22.7%, p = 0.74; TVR = 14.8% vs. 11.5%, p = 0.44; target lesion revascularization = 9.6% vs. 9.3%, p = 0.84).

CONCLUSIONS:

DEB may have a role in the treatment of diffuse de novo CAD, either alone in smaller vessels or in combination with DES in very long disease.

• Authors: Charis Costopoulos, Azeem Latib, Toru Naganuma, Alessandro Sticchi, Filippo Figini, Sandeep Basavarajaiah, Mauro Carlino, Alaide Chieffo, Matteo Montorfano, Charbel Naim, Masanori Kawaguchi, Francesco Giannini, Antonio Colombo
• Journal: JACC. Cardiovascular interventions (JACC Cardiovasc Interv) Vol. 6 Issue 11 Pg. 1153-9 (Nov 2013) ISSN: 1876-7605 [Electronic] United States
• PMID: 24262615 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Observational Study)
• Copyright: Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Chemical References

• Cardiovascular Agents
• Coated Materials, Biocompatible

Topics

• Aged
• Angioplasty, Balloon, Coronary (adverse effects, instrumentation, mortality)
• Cardiac Catheters
• Cardiovascular Agents (administration & dosage)
• Coated Materials, Biocompatible
• Coronary Angiography
• Coronary Artery Disease (diagnosis, mortality, therapy)
• Coronary Restenosis (etiology)
• Drug-Eluting Stents
• Female
• Hospitals, High-Volume
• Humans
• Italy
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Prosthesis Design
• Retrospective Studies
• Risk Factors
• Time Factors
• Treatment Outcome