Assessment of efficacy and safety of combining "paclitaxel" eluting balloon and "limus" eluting stent in the same lesion

Sandeep Basavarajaiah, Azeem Latib, Tasuku Hasegawa, Ahmed Rezq, Kensuke Takagi, Toru Naganuma, Masa Kawaguchi, Filippo Figini, Antonio Colombo

Research output: Contribution to journalArticle

Abstract

Objectives To assess the safety and efficacy of combining drug-eluting balloon (DEB) and drug-eluting stents (DES) in the same coronary lesion. Background Use of DEB may not always produce optimal results or even result in dissection, compelling the operators to consider bailout stenting with bare metal stents (BMS). However, BMS may not be ideal in patients who have significant risk-profile for restenosis. We have opted for DES over BMS in such situations and present our follow-up data. Methods Between 2009 and 2011, 46 patients (57 lesions) requiring bailout stenting following DEB use were treated with second-generation DES. All patients had at-least one or more risk-factors that made them vulnerable for restenosis (diabetes, chronic kidney disease, previous in-stent restenosis [ISR], and/or long diffuse lesions ≥30 mm). Results Of the 57 lesions, 34 (60%) were previous ISR. The mean length of the DEB was: 36.2 ± 5.6 mm. All patients had TIMI-3 flow post PCI with no in-lab complications. At median follow-up of 12.3 months (interquartile range [IQR]: 7.5-18.1), the rates target lesion revascularization (TLR) and target vessel revascularization (TVR) were 3 (5.3%) and 4 (7%), respectively. One patient had died 3 months following treatment. There were no episodes of myocardial infarction, definite or probable stent thrombosis. The major adverse cardiovascular events (MACE) rate defined as cardiac-death, MI, and TVR occurred in 11% of patients. Conclusion The results from this novel strategy of combining "Paclitaxel" eluting balloon and "Limus" eluting stent in a same lesion are encouraging. Dual drug-elution acting on two different pathways may provide potential synergy that may explain the favorable outcome. (J Interven Cardiol 2013;26:259-263)

Original languageEnglish
Pages (from-to)259-263
Number of pages5
JournalJournal of Interventional Cardiology
Volume26
Issue number3
DOIs
Publication statusPublished - Jun 2013

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Paclitaxel
Stents
Safety
Drug-Eluting Stents
Pharmaceutical Preparations
Metals
Chronic Renal Insufficiency
Dissection
Thrombosis
Myocardial Infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

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Assessment of efficacy and safety of combining "paclitaxel" eluting balloon and "limus" eluting stent in the same lesion. / Basavarajaiah, Sandeep; Latib, Azeem; Hasegawa, Tasuku; Rezq, Ahmed; Takagi, Kensuke; Naganuma, Toru; Kawaguchi, Masa; Figini, Filippo; Colombo, Antonio.

In: Journal of Interventional Cardiology, Vol. 26, No. 3, 06.2013, p. 259-263.

Research output: Contribution to journalArticle

Basavarajaiah, S, Latib, A, Hasegawa, T, Rezq, A, Takagi, K, Naganuma, T, Kawaguchi, M, Figini, F & Colombo, A 2013, 'Assessment of efficacy and safety of combining "paclitaxel" eluting balloon and "limus" eluting stent in the same lesion', Journal of Interventional Cardiology, vol. 26, no. 3, pp. 259-263. https://doi.org/10.1111/j.1540-8183.2013.12010.x
Basavarajaiah, Sandeep ; Latib, Azeem ; Hasegawa, Tasuku ; Rezq, Ahmed ; Takagi, Kensuke ; Naganuma, Toru ; Kawaguchi, Masa ; Figini, Filippo ; Colombo, Antonio. / Assessment of efficacy and safety of combining "paclitaxel" eluting balloon and "limus" eluting stent in the same lesion. In: Journal of Interventional Cardiology. 2013 ; Vol. 26, No. 3. pp. 259-263.
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abstract = "Objectives To assess the safety and efficacy of combining drug-eluting balloon (DEB) and drug-eluting stents (DES) in the same coronary lesion. Background Use of DEB may not always produce optimal results or even result in dissection, compelling the operators to consider bailout stenting with bare metal stents (BMS). However, BMS may not be ideal in patients who have significant risk-profile for restenosis. We have opted for DES over BMS in such situations and present our follow-up data. Methods Between 2009 and 2011, 46 patients (57 lesions) requiring bailout stenting following DEB use were treated with second-generation DES. All patients had at-least one or more risk-factors that made them vulnerable for restenosis (diabetes, chronic kidney disease, previous in-stent restenosis [ISR], and/or long diffuse lesions ≥30 mm). Results Of the 57 lesions, 34 (60{\%}) were previous ISR. The mean length of the DEB was: 36.2 ± 5.6 mm. All patients had TIMI-3 flow post PCI with no in-lab complications. At median follow-up of 12.3 months (interquartile range [IQR]: 7.5-18.1), the rates target lesion revascularization (TLR) and target vessel revascularization (TVR) were 3 (5.3{\%}) and 4 (7{\%}), respectively. One patient had died 3 months following treatment. There were no episodes of myocardial infarction, definite or probable stent thrombosis. The major adverse cardiovascular events (MACE) rate defined as cardiac-death, MI, and TVR occurred in 11{\%} of patients. Conclusion The results from this novel strategy of combining {"}Paclitaxel{"} eluting balloon and {"}Limus{"} eluting stent in a same lesion are encouraging. Dual drug-elution acting on two different pathways may provide potential synergy that may explain the favorable outcome. (J Interven Cardiol 2013;26:259-263)",
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AU - Rezq, Ahmed

AU - Takagi, Kensuke

AU - Naganuma, Toru

AU - Kawaguchi, Masa

AU - Figini, Filippo

AU - Colombo, Antonio

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AB - Objectives To assess the safety and efficacy of combining drug-eluting balloon (DEB) and drug-eluting stents (DES) in the same coronary lesion. Background Use of DEB may not always produce optimal results or even result in dissection, compelling the operators to consider bailout stenting with bare metal stents (BMS). However, BMS may not be ideal in patients who have significant risk-profile for restenosis. We have opted for DES over BMS in such situations and present our follow-up data. Methods Between 2009 and 2011, 46 patients (57 lesions) requiring bailout stenting following DEB use were treated with second-generation DES. All patients had at-least one or more risk-factors that made them vulnerable for restenosis (diabetes, chronic kidney disease, previous in-stent restenosis [ISR], and/or long diffuse lesions ≥30 mm). Results Of the 57 lesions, 34 (60%) were previous ISR. The mean length of the DEB was: 36.2 ± 5.6 mm. All patients had TIMI-3 flow post PCI with no in-lab complications. At median follow-up of 12.3 months (interquartile range [IQR]: 7.5-18.1), the rates target lesion revascularization (TLR) and target vessel revascularization (TVR) were 3 (5.3%) and 4 (7%), respectively. One patient had died 3 months following treatment. There were no episodes of myocardial infarction, definite or probable stent thrombosis. The major adverse cardiovascular events (MACE) rate defined as cardiac-death, MI, and TVR occurred in 11% of patients. Conclusion The results from this novel strategy of combining "Paclitaxel" eluting balloon and "Limus" eluting stent in a same lesion are encouraging. Dual drug-elution acting on two different pathways may provide potential synergy that may explain the favorable outcome. (J Interven Cardiol 2013;26:259-263)

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