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

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

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)e1589-e1595
JournalEuroIntervention
Volume11
Issue number14
DOIs
Publication statusPublished - Apr 1 2016

Keywords

  • Angioplasty
  • Bioresorbable scaffold
  • Diffuse coronary artery disease
  • Drug-coated balloon
  • Outcomes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Ielasi, A., Miyazaki, T., Geraci, S., Testa, L., Abdel-Wahab, M., Kawamoto, H., Ruparelia, N., Sato, T., Caramanno, G., Bedogni, F., Tespili, M., Colombo, A., & Latib, A. (2016). Hybrid strategy with a bioresorbable scaffold and a drug-coated balloon for diffuse coronary artery disease: The "no more metallic cages" multicentre pilot experience. EuroIntervention, 11(14), e1589-e1595. https://doi.org/10.4244/EIJV11I14A309