Hybrid strategy with a bioresorbable scaffold and a drug-coated balloon for diffuse coronary artery disease: the "no more metallic cages" multicentre pilot experience.

Abstract

AIMS:

Our aim was to assess the feasibility and results of a hybrid approach with a bioresorbable scaffold (BRS) plus a drug-coated balloon (DCB) for the treatment of diffuse coronary artery disease (CAD).

METHODS AND RESULTS:

A retrospective analysis was performed on consecutive patients with diffuse de novo or in-stent restenosis treated with BRS implantation (larger proximal segment) and DCB inflation (smaller distal segment or bifurcation side branch). Endpoints were procedural success, then ischaemia-driven target lesion revascularisation (ID-TLR) and BRS/DCB segment thrombosis rates at follow-up. A total of 42 consecutive patients were treated with the hybrid strategy. Mean patient age was 62±1.02 years, while 12 (28.6%) patients were diabetics. Mean BRS and DCB length were 28.0±5.1 mm and 25.8±8.8 mm, respectively. Procedural success was obtained in all patients, but three (7.3%) patients required bail-out scaffolding for DCB-related dissection. At a median follow-up of 12 months (IQR: 6-18), there were no cases of cardiac death, target vessel myocardial infarction, or BRS/DCB segment thrombosis. ID-TLR occurred in two (4.7%) BRS-treated segments.

CONCLUSIONS:

Our data in consecutive patients with diffuse CAD suggest that a hybrid strategy using BRS and DCB in different segments of the diseased vessel is feasible and associated with encouraging clinical outcomes.

• Authors: Alfonso Ielasi, Tadashi Miyazaki, Salvatore Geraci, Luca Testa, Mohamed Abdel-Wahab, Hiroyoshi Kawamoto, Neil Ruparelia, Takao Sato, Giuseppe Caramanno, Francesco Bedogni, Maurizio Tespili, Antonio Colombo, Azeem Latib
• Journal: EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology (EuroIntervention) Vol. 11 Issue 14 Pg. e1589-95 (Apr 08 2016) ISSN: 1969-6213 [Electronic] France
• PMID: 27056119 (Publication Type: Journal Article)

Topics

• Absorbable Implants
• Aged
• Angioplasty, Balloon, Coronary (methods)
• Coronary Artery Disease (surgery)
• Coronary Restenosis (surgery)
• Drug-Eluting Stents (adverse effects)
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Myocardial Infarction (surgery)
• Pilot Projects
• Retrospective Studies
• Treatment Outcome