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

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Coronary Artery Disease
Pharmaceutical Preparations
Thrombosis
Ischemia
Economic Inflation
Stents
Dissection
Myocardial Infarction

Keywords

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Hybrid strategy with a bioresorbable scaffold and a drug-coated balloon for diffuse coronary artery disease : The "no more metallic cages" multicentre pilot experience. / Ielasi, Alfonso; Miyazaki, Tadashi; Geraci, Salvatore; Testa, Luca; Abdel-Wahab, Mohamed; Kawamoto, Hiroyoshi; Ruparelia, Neil; Sato, Takao; Caramanno, Giuseppe; Bedogni, Francesco; Tespili, Maurizio; Colombo, Antonio; Latib, Azeem.

In: EuroIntervention, Vol. 11, No. 14, 01.04.2016, p. e1589-e1595.

Research output: Contribution to journalArticle

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, vol. 11, no. 14, pp. e1589-e1595. https://doi.org/10.4244/EIJV11I14A309
Ielasi, Alfonso ; Miyazaki, Tadashi ; Geraci, Salvatore ; Testa, Luca ; Abdel-Wahab, Mohamed ; Kawamoto, Hiroyoshi ; Ruparelia, Neil ; Sato, Takao ; Caramanno, Giuseppe ; Bedogni, Francesco ; Tespili, Maurizio ; Colombo, Antonio ; Latib, Azeem. / Hybrid strategy with a bioresorbable scaffold and a drug-coated balloon for diffuse coronary artery disease : The "no more metallic cages" multicentre pilot experience. In: EuroIntervention. 2016 ; Vol. 11, No. 14. pp. e1589-e1595.
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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.",
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AU - Ielasi, Alfonso

AU - Miyazaki, Tadashi

AU - Geraci, Salvatore

AU - Testa, Luca

AU - Abdel-Wahab, Mohamed

AU - Kawamoto, Hiroyoshi

AU - Ruparelia, Neil

AU - Sato, Takao

AU - Caramanno, Giuseppe

AU - Bedogni, Francesco

AU - Tespili, Maurizio

AU - Colombo, Antonio

AU - Latib, Azeem

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N2 - 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.

AB - 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.

KW - Angioplasty

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KW - Diffuse coronary artery disease

KW - Drug-coated balloon

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