Do we believe in drug-coated balloons – a single-center retrospective analysis

    Authors

    Abstract

    **Introduction**: Drug-coated balloon (DCB) percutaneous coronary intervention (PCI) is the concept of treating coronary stenosis avoiding stent implantations. This „leave nothing behind“ concept is very attractive but still it is reserved for the minority of patients’ scenarios. While in small vessels (3.0mm) randomized data are lacking but there is growing evidence for the efficacy and safety. Also, there is little data favoring treating side branch bifurcation lesions while there is no data to support DCB-only concept in true bifurcation lesions. (1-3) **Patients and Methods**: We analyzed data from the hospital information system and web-based database (CAD register) of patients who underwent urgent and elective PCI procedure in the General Hospital “Dr. Josip Benčević” in the last 3 years. CAD register was created in 2019 and contains patient and procedure specific information. We analyzed percentage of all DCB interventions, in stent restenosis (ISR) – de novo lesions ratio, and subanalysis of chronic vs acute coronary syndromes (CCS vs ACS) de novo lesions. **Results**: In 2020 there were 29 (5.6%) DCB interventions of total PCI procedures, with 8 (27.6%) de novo DCB-only interventions. In 2021 we performed 48 (7.9%) DCB interventions and 26 (54. 2%) de novo DCB-only interventions, while in 2022 we performed 78 (12.6%) and 44 (56.4%) de novo DCB-only interventions. Most interventions were for acute coronary events 58 (74.3%), with TIMI 3 flow established in culprit vessels in more than 85% of cases, mostly in small vessels. **Conclusion:** Use of the DCB only strategy for de novo lesions has tripled overall in 3 years at our institution. According to our experience, DCB-only PCI is safe and efficient strategy for treating variety of patients including STEMI. The advancements of DCB technologies facilitated the treatment of DCB only de novo lesions. Future studies are needed to evaluate the efficacy and safety DCB in large vessel interventions especially in diffuse atherosclerotic disease and bifurcations.

    Keywords

    coated balloons, stent, chronic coronary syndromes, bifurcation lesions

    DOI

    https://doi.org/10.15836/ccar2023.69

    Literature

    1. Cortese B, Micheli A, Picchi A, Coppolaro A, Bandinelli L, Severi S, et al. Paclitaxel-coated balloon versus drug-eluting stent during PCI of small coronary vessels, a prospective randomised clinical trial. The PICCOLETO study. Heart. 2010 August;96(16):1291–6. https://doi.org/10.1136/hrt.2010.195057
    2. Jeger RV, Farah A, Ohlow MA, Mangner N, Möbius-Winkler S, Weilenmann D, et al. BASKET-SMALL 2 Investigators. Long-term efficacy and safety of drug-coated balloons versus drug-eluting stents for small coronary artery disease (BASKET-SMALL 2): 3-year follow-up of a randomised, non-inferiority trial. Lancet. 2020 November 7;396(10261):1504–10. https://doi.org/10.1016/S0140-6736(20)32173-5
    3. Tang Y, Qiao S, Su X, Chen Y, Jin Z, Chen H, et al. Drug-Coated Balloon Versus Drug-Eluting Stent for Small-Vessel Disease: The RESTORE SVD China Randomized Trial. JACC Cardiovasc Interv. 2018 December 10;11(23):2381–92. https://doi.org/10.1016/j.jcin.2018.09.009
    Cardiologia Croatica
    Back to search

    Do we believe in drug-coated balloons – a single-center retrospective analysis

    Extended Abstract
    Issue3-4
    Published
    Pages69
    PDF via DOIhttps://doi.org/10.15836/ccar2023.69
    coated balloons
    stent
    chronic coronary syndromes
    bifurcation lesions

    Authors

    Krešimir Gabaldo*ORCIDGeneral Hospital “Dr. Josip Benčević” Slavonski Brod, Slavonski Brod, Croatia
    Ivan BitunjacORCIDGeneral Hospital “Dr. Josip Benčević” Slavonski Brod, Slavonski Brod, Croatia
    Domagoj MiškovićORCIDGeneral Hospital “Dr. Josip Benčević” Slavonski Brod, Slavonski Brod, Croatia
    Marijana Knežević PravečekORCIDGeneral Hospital “Dr. Josip Benčević” Slavonski Brod, Slavonski Brod, Croatia
    Antonija RagužORCIDGeneral Hospital “Dr. Josip Benčević” Slavonski Brod, Slavonski Brod, Croatia
    Blaženka MiškićORCIDGeneral Hospital “Dr. Josip Benčević” Slavonski Brod, Slavonski Brod, Croatia
    Ivica DunđerORCIDGeneral Hospital “Dr. Josip Benčević” Slavonski Brod, Slavonski Brod, Croatia
    Katica Cvitkušić LukendaORCIDGeneral Hospital “Dr. Josip Benčević” Slavonski Brod, Slavonski Brod, Croatia

    *Correspondence email: kresimir.gabaldo@gmail.com

    Abstract

    **Introduction**: Drug-coated balloon (DCB) percutaneous coronary intervention (PCI) is the concept of treating coronary stenosis avoiding stent implantations. This „leave nothing behind“ concept is very attractive but still it is reserved for the minority of patients’ scenarios. While in small vessels (3.0mm) randomized data are lacking but there is growing evidence for the efficacy and safety. Also, there is little data favoring treating side branch bifurcation lesions while there is no data to support DCB-only concept in true bifurcation lesions. (1-3) **Patients and Methods**: We analyzed data from the hospital information system and web-based database (CAD register) of patients who underwent urgent and elective PCI procedure in the General Hospital “Dr. Josip Benčević” in the last 3 years. CAD register was created in 2019 and contains patient and procedure specific information. We analyzed percentage of all DCB interventions, in stent restenosis (ISR) – de novo lesions ratio, and subanalysis of chronic vs acute coronary syndromes (CCS vs ACS) de novo lesions. **Results**: In 2020 there were 29 (5.6%) DCB interventions of total PCI procedures, with 8 (27.6%) de novo DCB-only interventions. In 2021 we performed 48 (7.9%) DCB interventions and 26 (54. 2%) de novo DCB-only interventions, while in 2022 we performed 78 (12.6%) and 44 (56.4%) de novo DCB-only interventions. Most interventions were for acute coronary events 58 (74.3%), with TIMI 3 flow established in culprit vessels in more than 85% of cases, mostly in small vessels. **Conclusion:** Use of the DCB only strategy for de novo lesions has tripled overall in 3 years at our institution. According to our experience, DCB-only PCI is safe and efficient strategy for treating variety of patients including STEMI. The advancements of DCB technologies facilitated the treatment of DCB only de novo lesions. Future studies are needed to evaluate the efficacy and safety DCB in large vessel interventions especially in diffuse atherosclerotic disease and bifurcations.

    Literature

    1. 1.
      Cortese B, Micheli A, Picchi A, Coppolaro A, Bandinelli L, Severi S, et al. Paclitaxel-coated balloon versus drug-eluting stent during PCI of small coronary vessels, a prospective randomised clinical trial. The PICCOLETO study. Heart. 2010 August;96(16):1291–6.DOI
    2. 2.
      Jeger RV, Farah A, Ohlow MA, Mangner N, Möbius-Winkler S, Weilenmann D, et al. BASKET-SMALL 2 Investigators. Long-term efficacy and safety of drug-coated balloons versus drug-eluting stents for small coronary artery disease (BASKET-SMALL 2): 3-year follow-up of a randomised, non-inferiority trial. Lancet. 2020 November 7;396(10261):1504–10.DOI
    3. 3.
      Tang Y, Qiao S, Su X, Chen Y, Jin Z, Chen H, et al. Drug-Coated Balloon Versus Drug-Eluting Stent for Small-Vessel Disease: The RESTORE SVD China Randomized Trial. JACC Cardiovasc Interv. 2018 December 10;11(23):2381–92.DOI