The role of drug-eluting balloons alone or in combination with drug-eluting stents in the treatment of de novo diffuse coronary disease

Charis Costopoulos, Azeem Latib, Toru Naganuma, Alessandro Sticchi, Filippo Figini, Sandeep Basavarajaiah, Mauro Carlino, Alaide Chieffo, Matteo Montorfano, Charbel Naim, Masanori Kawaguchi, Francesco Giannini, Antonio Colombo

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Abstract

Objectives This study sought to investigate the role of drug-eluting balloons (DEB) alone or in combination with drug-eluting stents (DES) in the treatment of diffuse de novo coronary artery disease (CAD) (>25 mm). Background The use of DEB in diffuse CAD, either alone or in combination with DES, offers an alternative to stenting alone. Data regarding DEB in this context are limited. Methods We retrospectively evaluated all patients treated with DEB for diffuse CAD between June 2009 and October 2012. Endpoints analyzed were major adverse cardiac events, defined as all-cause death, myocardial infarction, and target vessel revascularization (TVR), as well as TVR and target lesion revascularization separately. Results were compared with those obtained from a cohort of patients with similar characteristics treated with DES alone. Results A total of 69 patients (93 lesions) were treated with DEB ± DES, and 93 patients with DES alone (93 lesions). A high proportion of patients were diabetic (46.4% vs. 44.1%, p = 0.77). Of the DEB-treated lesions, 56.0% were treated with DEB alone, 7.4% with DEB and DES as bail out, and 36.6% with DES and DEB as part of a hybrid approach for very long disease. Outcome rates with DEB ± DES were comparable to those with DES alone at 2-year follow-up (major adverse cardiac events = 20.8% vs. 22.7%, p = 0.74; TVR = 14.8% vs. 11.5%, p = 0.44; target lesion revascularization = 9.6% vs. 9.3%, p = 0.84). Conclusions DEB may have a role in the treatment of diffuse de novo CAD, either alone in smaller vessels or in combination with DES in very long disease.

Original languageEnglish
Pages (from-to)1153-1159
Number of pages7
JournalJACC: Cardiovascular Interventions
Volume6
Issue number11
DOIs
Publication statusPublished - Nov 2013

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Drug-Eluting Stents
Coronary Disease
Pharmaceutical Preparations
Coronary Artery Disease
Therapeutics
Cause of Death
Myocardial Infarction

Keywords

  • diffuse coronary artery disease
  • drug-eluting balloon(s)
  • drug-eluting stent(s)
  • target lesion revascularization

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

The role of drug-eluting balloons alone or in combination with drug-eluting stents in the treatment of de novo diffuse coronary disease. / Costopoulos, Charis; Latib, Azeem; Naganuma, Toru; Sticchi, Alessandro; Figini, Filippo; Basavarajaiah, Sandeep; Carlino, Mauro; Chieffo, Alaide; Montorfano, Matteo; Naim, Charbel; Kawaguchi, Masanori; Giannini, Francesco; Colombo, Antonio.

In: JACC: Cardiovascular Interventions, Vol. 6, No. 11, 11.2013, p. 1153-1159.

Research output: Contribution to journalArticle

Costopoulos, C, Latib, A, Naganuma, T, Sticchi, A, Figini, F, Basavarajaiah, S, Carlino, M, Chieffo, A, Montorfano, M, Naim, C, Kawaguchi, M, Giannini, F & Colombo, A 2013, 'The role of drug-eluting balloons alone or in combination with drug-eluting stents in the treatment of de novo diffuse coronary disease', JACC: Cardiovascular Interventions, vol. 6, no. 11, pp. 1153-1159. https://doi.org/10.1016/j.jcin.2013.07.005
Costopoulos, Charis ; Latib, Azeem ; Naganuma, Toru ; Sticchi, Alessandro ; Figini, Filippo ; Basavarajaiah, Sandeep ; Carlino, Mauro ; Chieffo, Alaide ; Montorfano, Matteo ; Naim, Charbel ; Kawaguchi, Masanori ; Giannini, Francesco ; Colombo, Antonio. / The role of drug-eluting balloons alone or in combination with drug-eluting stents in the treatment of de novo diffuse coronary disease. In: JACC: Cardiovascular Interventions. 2013 ; Vol. 6, No. 11. pp. 1153-1159.
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title = "The role of drug-eluting balloons alone or in combination with drug-eluting stents in the treatment of de novo diffuse coronary disease",
abstract = "Objectives This study sought to investigate the role of drug-eluting balloons (DEB) alone or in combination with drug-eluting stents (DES) in the treatment of diffuse de novo coronary artery disease (CAD) (>25 mm). Background The use of DEB in diffuse CAD, either alone or in combination with DES, offers an alternative to stenting alone. Data regarding DEB in this context are limited. Methods We retrospectively evaluated all patients treated with DEB for diffuse CAD between June 2009 and October 2012. Endpoints analyzed were major adverse cardiac events, defined as all-cause death, myocardial infarction, and target vessel revascularization (TVR), as well as TVR and target lesion revascularization separately. Results were compared with those obtained from a cohort of patients with similar characteristics treated with DES alone. Results A total of 69 patients (93 lesions) were treated with DEB ± DES, and 93 patients with DES alone (93 lesions). A high proportion of patients were diabetic (46.4{\%} vs. 44.1{\%}, p = 0.77). Of the DEB-treated lesions, 56.0{\%} were treated with DEB alone, 7.4{\%} with DEB and DES as bail out, and 36.6{\%} with DES and DEB as part of a hybrid approach for very long disease. Outcome rates with DEB ± DES were comparable to those with DES alone at 2-year follow-up (major adverse cardiac events = 20.8{\%} vs. 22.7{\%}, p = 0.74; TVR = 14.8{\%} vs. 11.5{\%}, p = 0.44; target lesion revascularization = 9.6{\%} vs. 9.3{\%}, p = 0.84). Conclusions DEB may have a role in the treatment of diffuse de novo CAD, either alone in smaller vessels or in combination with DES in very long disease.",
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T1 - The role of drug-eluting balloons alone or in combination with drug-eluting stents in the treatment of de novo diffuse coronary disease

AU - Costopoulos, Charis

AU - Latib, Azeem

AU - Naganuma, Toru

AU - Sticchi, Alessandro

AU - Figini, Filippo

AU - Basavarajaiah, Sandeep

AU - Carlino, Mauro

AU - Chieffo, Alaide

AU - Montorfano, Matteo

AU - Naim, Charbel

AU - Kawaguchi, Masanori

AU - Giannini, Francesco

AU - Colombo, Antonio

PY - 2013/11

Y1 - 2013/11

N2 - Objectives This study sought to investigate the role of drug-eluting balloons (DEB) alone or in combination with drug-eluting stents (DES) in the treatment of diffuse de novo coronary artery disease (CAD) (>25 mm). Background The use of DEB in diffuse CAD, either alone or in combination with DES, offers an alternative to stenting alone. Data regarding DEB in this context are limited. Methods We retrospectively evaluated all patients treated with DEB for diffuse CAD between June 2009 and October 2012. Endpoints analyzed were major adverse cardiac events, defined as all-cause death, myocardial infarction, and target vessel revascularization (TVR), as well as TVR and target lesion revascularization separately. Results were compared with those obtained from a cohort of patients with similar characteristics treated with DES alone. Results A total of 69 patients (93 lesions) were treated with DEB ± DES, and 93 patients with DES alone (93 lesions). A high proportion of patients were diabetic (46.4% vs. 44.1%, p = 0.77). Of the DEB-treated lesions, 56.0% were treated with DEB alone, 7.4% with DEB and DES as bail out, and 36.6% with DES and DEB as part of a hybrid approach for very long disease. Outcome rates with DEB ± DES were comparable to those with DES alone at 2-year follow-up (major adverse cardiac events = 20.8% vs. 22.7%, p = 0.74; TVR = 14.8% vs. 11.5%, p = 0.44; target lesion revascularization = 9.6% vs. 9.3%, p = 0.84). Conclusions DEB may have a role in the treatment of diffuse de novo CAD, either alone in smaller vessels or in combination with DES in very long disease.

AB - Objectives This study sought to investigate the role of drug-eluting balloons (DEB) alone or in combination with drug-eluting stents (DES) in the treatment of diffuse de novo coronary artery disease (CAD) (>25 mm). Background The use of DEB in diffuse CAD, either alone or in combination with DES, offers an alternative to stenting alone. Data regarding DEB in this context are limited. Methods We retrospectively evaluated all patients treated with DEB for diffuse CAD between June 2009 and October 2012. Endpoints analyzed were major adverse cardiac events, defined as all-cause death, myocardial infarction, and target vessel revascularization (TVR), as well as TVR and target lesion revascularization separately. Results were compared with those obtained from a cohort of patients with similar characteristics treated with DES alone. Results A total of 69 patients (93 lesions) were treated with DEB ± DES, and 93 patients with DES alone (93 lesions). A high proportion of patients were diabetic (46.4% vs. 44.1%, p = 0.77). Of the DEB-treated lesions, 56.0% were treated with DEB alone, 7.4% with DEB and DES as bail out, and 36.6% with DES and DEB as part of a hybrid approach for very long disease. Outcome rates with DEB ± DES were comparable to those with DES alone at 2-year follow-up (major adverse cardiac events = 20.8% vs. 22.7%, p = 0.74; TVR = 14.8% vs. 11.5%, p = 0.44; target lesion revascularization = 9.6% vs. 9.3%, p = 0.84). Conclusions DEB may have a role in the treatment of diffuse de novo CAD, either alone in smaller vessels or in combination with DES in very long disease.

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KW - drug-eluting balloon(s)

KW - drug-eluting stent(s)

KW - target lesion revascularization

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