|
1
|
Adjei-Sefah K, Sahyouni M, Stouffer GA. Drug-coated Balloons for De Novo Lesions in Large Coronary Arteries-Are They Ready for Prime Time? Cardiovasc Drugs Ther 2025:10.1007/s10557-025-07719-9. [PMID: 40402392 DOI: 10.1007/s10557-025-07719-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/14/2025] [Indexed: 05/23/2025]
Affiliation(s)
- Kwame Adjei-Sefah
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, 27599-7075, NC, USA
| | - Mark Sahyouni
- Campbell University School of Osteopathic Medicine, Lillington, NC, USA
| | - George A Stouffer
- Division of Cardiology and the McAllister Heart Institute, University of North Carolina, Chapel Hill, 27599-7075, NC, USA.
| |
Collapse
|
|
2
|
Lazar FL, Onea HL, Homorodean C, Bitea IC, Lazar DR, Ober MC, Tataru D, Olinic M, Spinu M, Kacso TP, Olinic DM. Drug-Coated Balloons in All-Comer Population-Are We There Yet? J Clin Med 2025; 14:3608. [PMID: 40429603 PMCID: PMC12112292 DOI: 10.3390/jcm14103608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2025] [Revised: 05/11/2025] [Accepted: 05/19/2025] [Indexed: 05/29/2025] Open
Abstract
With the advancement of interventional coronary procedures, drug-coated balloons have become an increasingly common alternative to drug-eluting stents in the treatment of various lesions. This paradigm shift stems from several advantages that DCBs entail, including a reduction in stent length burden, the possibility of late vessel positive remodeling, and the preservation of bifurcation anatomy. Conversely, several studies compared the efficacy of DCB treatment to stents or POBA in various scenarios. In this review, we will discuss the areas in which a DCB can be of paramount importance. We will begin by examining the role of DCBs in in-stent restenosis, for which the current practice guidelines do not clearly state the role of this technology, as opposed to the previous ones, in which it was mentioned as a first-line armamentarium. We will then discuss the indications and advantages of using DCBs in de novo lesions, concerning both small and large vessels, with growing emphasis on diffuse lesions. Lastly, we will address the current data on the use of DCBs in special scenarios such as the treatment of chronic total occlusion and left main and bifurcation lesions, without forgetting the primordial role of drug-eluting stents in all these lesions.
Collapse
Affiliation(s)
- Florin-Leontin Lazar
- Medical Clinic Number 1, 4th Department of Internal Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (F.-L.L.); (D.T.); (M.O.); (M.S.); (D.-M.O.)
- County Emergency Hospital, 550245 Sibiu, Romania;
| | - Horea Laurentiu Onea
- Medical Clinic Number 1, 4th Department of Internal Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (F.-L.L.); (D.T.); (M.O.); (M.S.); (D.-M.O.)
- County Emergency Hospital, 550245 Sibiu, Romania;
| | - Calin Homorodean
- Medical Clinic Number 1, 4th Department of Internal Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (F.-L.L.); (D.T.); (M.O.); (M.S.); (D.-M.O.)
- Department of Interventional Cardiology, Cluj County Emergency Hospital, 400006 Cluj-Napoca, Romania; (M.C.O.); (T.P.K.)
| | | | - Diana Raluca Lazar
- 10th Department of Oncology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Mihai Claudiu Ober
- Department of Interventional Cardiology, Cluj County Emergency Hospital, 400006 Cluj-Napoca, Romania; (M.C.O.); (T.P.K.)
| | - Dan Tataru
- Medical Clinic Number 1, 4th Department of Internal Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (F.-L.L.); (D.T.); (M.O.); (M.S.); (D.-M.O.)
- Department of Interventional Cardiology, Cluj County Emergency Hospital, 400006 Cluj-Napoca, Romania; (M.C.O.); (T.P.K.)
| | - Maria Olinic
- Medical Clinic Number 1, 4th Department of Internal Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (F.-L.L.); (D.T.); (M.O.); (M.S.); (D.-M.O.)
- Department of Interventional Cardiology, Cluj County Emergency Hospital, 400006 Cluj-Napoca, Romania; (M.C.O.); (T.P.K.)
| | - Mihail Spinu
- Medical Clinic Number 1, 4th Department of Internal Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (F.-L.L.); (D.T.); (M.O.); (M.S.); (D.-M.O.)
- Department of Interventional Cardiology, Cluj County Emergency Hospital, 400006 Cluj-Napoca, Romania; (M.C.O.); (T.P.K.)
| | - Teodor Paul Kacso
- Department of Interventional Cardiology, Cluj County Emergency Hospital, 400006 Cluj-Napoca, Romania; (M.C.O.); (T.P.K.)
| | - Dan-Mircea Olinic
- Medical Clinic Number 1, 4th Department of Internal Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (F.-L.L.); (D.T.); (M.O.); (M.S.); (D.-M.O.)
- Department of Interventional Cardiology, Cluj County Emergency Hospital, 400006 Cluj-Napoca, Romania; (M.C.O.); (T.P.K.)
| |
Collapse
|
|
3
|
Merinopoulos I, U B, Gunawardena T, Corballis N, Natarajan R, Wickramarachchi U, Maart C, Sreekumar S, Sawh C, Reinhold J, Wistow T, Ryding A, Gilbert T, Vassiliou VS, Eccleshall SC. Assessment of Paclitaxel Drug-Coated Balloon-Only Angioplasty for Stent Thrombosis: SPARTAN-ST Study. J Cardiovasc Dev Dis 2025; 12:59. [PMID: 39997492 PMCID: PMC11856968 DOI: 10.3390/jcdd12020059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2024] [Revised: 01/29/2025] [Accepted: 01/30/2025] [Indexed: 02/26/2025] Open
Abstract
BACKGROUND There are no data regarding the outcomes of patients with stent thrombosis (ST) being treated with drug-coated balloon (DCB) angioplasty. Our aim was to compare the outcomes of patients with ST treated with DCB vs. a drug eluting stent (DES). METHODS In this registry analysis, we identified all patients treated for ST in our institution from June 2011 until November 2019. We excluded patients who died in the cath lab, patients with uncrossable lesions, and patients treated with thrombectomy only. Patient outcomes were obtained from Hospital Episodes Statistics from NHS England. The primary endpoint of this study was the composite of cardiovascular mortality, acute coronary syndrome, or target lesion revascularisation. The data were analysed with Cox regression and Kaplan-Meier estimator plots. RESULTS A total of 173 patients were identified; 92 treated with DCB-only, 36 with balloon angioplasty (BA), 26 with DES, and 19 with a combination of DES and DCB. We compared the outcomes of 92 patients with DCB versus 20 patients with DES, all of which had presented with late or very late ST. There was no difference between DCB and DES in terms of the primary endpoint (p = 0.06). Multivariate analysis identified diabetes (adverse) and the use of GPIIbIIIa inhibitor (favourable) as the only independent predictors of the primary endpoint. Implantation of a DES was independently associated with worse cardiovascular mortality. CONCLUSIONS This is the first study assessing the outcomes of patients with ST treated with DCB only. It has demonstrated that DCBs are an attractive therapeutic option with a tendency towards favourable outcomes when compared to DESs.
Collapse
Affiliation(s)
- Ioannis Merinopoulos
- Department of Cardiology, Norfolk and Norwich University Hospital, Colney Ln, Norwich NR4 7UY, UK; (B.U.); (T.G.); (N.C.); (R.N.); (U.W.); (C.M.); (S.S.); (C.S.); (J.R.); (T.W.); (A.R.); (T.G.); (V.S.V.); (S.C.E.)
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
| | - Bhalraam U
- Department of Cardiology, Norfolk and Norwich University Hospital, Colney Ln, Norwich NR4 7UY, UK; (B.U.); (T.G.); (N.C.); (R.N.); (U.W.); (C.M.); (S.S.); (C.S.); (J.R.); (T.W.); (A.R.); (T.G.); (V.S.V.); (S.C.E.)
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
| | - Tharusha Gunawardena
- Department of Cardiology, Norfolk and Norwich University Hospital, Colney Ln, Norwich NR4 7UY, UK; (B.U.); (T.G.); (N.C.); (R.N.); (U.W.); (C.M.); (S.S.); (C.S.); (J.R.); (T.W.); (A.R.); (T.G.); (V.S.V.); (S.C.E.)
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
| | - Natasha Corballis
- Department of Cardiology, Norfolk and Norwich University Hospital, Colney Ln, Norwich NR4 7UY, UK; (B.U.); (T.G.); (N.C.); (R.N.); (U.W.); (C.M.); (S.S.); (C.S.); (J.R.); (T.W.); (A.R.); (T.G.); (V.S.V.); (S.C.E.)
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
| | - Rajkumar Natarajan
- Department of Cardiology, Norfolk and Norwich University Hospital, Colney Ln, Norwich NR4 7UY, UK; (B.U.); (T.G.); (N.C.); (R.N.); (U.W.); (C.M.); (S.S.); (C.S.); (J.R.); (T.W.); (A.R.); (T.G.); (V.S.V.); (S.C.E.)
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
| | - Upul Wickramarachchi
- Department of Cardiology, Norfolk and Norwich University Hospital, Colney Ln, Norwich NR4 7UY, UK; (B.U.); (T.G.); (N.C.); (R.N.); (U.W.); (C.M.); (S.S.); (C.S.); (J.R.); (T.W.); (A.R.); (T.G.); (V.S.V.); (S.C.E.)
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
| | - Clint Maart
- Department of Cardiology, Norfolk and Norwich University Hospital, Colney Ln, Norwich NR4 7UY, UK; (B.U.); (T.G.); (N.C.); (R.N.); (U.W.); (C.M.); (S.S.); (C.S.); (J.R.); (T.W.); (A.R.); (T.G.); (V.S.V.); (S.C.E.)
| | - Sulfi Sreekumar
- Department of Cardiology, Norfolk and Norwich University Hospital, Colney Ln, Norwich NR4 7UY, UK; (B.U.); (T.G.); (N.C.); (R.N.); (U.W.); (C.M.); (S.S.); (C.S.); (J.R.); (T.W.); (A.R.); (T.G.); (V.S.V.); (S.C.E.)
| | - Chris Sawh
- Department of Cardiology, Norfolk and Norwich University Hospital, Colney Ln, Norwich NR4 7UY, UK; (B.U.); (T.G.); (N.C.); (R.N.); (U.W.); (C.M.); (S.S.); (C.S.); (J.R.); (T.W.); (A.R.); (T.G.); (V.S.V.); (S.C.E.)
| | - Johannes Reinhold
- Department of Cardiology, Norfolk and Norwich University Hospital, Colney Ln, Norwich NR4 7UY, UK; (B.U.); (T.G.); (N.C.); (R.N.); (U.W.); (C.M.); (S.S.); (C.S.); (J.R.); (T.W.); (A.R.); (T.G.); (V.S.V.); (S.C.E.)
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
| | - Trevor Wistow
- Department of Cardiology, Norfolk and Norwich University Hospital, Colney Ln, Norwich NR4 7UY, UK; (B.U.); (T.G.); (N.C.); (R.N.); (U.W.); (C.M.); (S.S.); (C.S.); (J.R.); (T.W.); (A.R.); (T.G.); (V.S.V.); (S.C.E.)
| | - Alisdair Ryding
- Department of Cardiology, Norfolk and Norwich University Hospital, Colney Ln, Norwich NR4 7UY, UK; (B.U.); (T.G.); (N.C.); (R.N.); (U.W.); (C.M.); (S.S.); (C.S.); (J.R.); (T.W.); (A.R.); (T.G.); (V.S.V.); (S.C.E.)
| | - Timothy Gilbert
- Department of Cardiology, Norfolk and Norwich University Hospital, Colney Ln, Norwich NR4 7UY, UK; (B.U.); (T.G.); (N.C.); (R.N.); (U.W.); (C.M.); (S.S.); (C.S.); (J.R.); (T.W.); (A.R.); (T.G.); (V.S.V.); (S.C.E.)
| | - Vassilios S. Vassiliou
- Department of Cardiology, Norfolk and Norwich University Hospital, Colney Ln, Norwich NR4 7UY, UK; (B.U.); (T.G.); (N.C.); (R.N.); (U.W.); (C.M.); (S.S.); (C.S.); (J.R.); (T.W.); (A.R.); (T.G.); (V.S.V.); (S.C.E.)
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
| | - Simon C. Eccleshall
- Department of Cardiology, Norfolk and Norwich University Hospital, Colney Ln, Norwich NR4 7UY, UK; (B.U.); (T.G.); (N.C.); (R.N.); (U.W.); (C.M.); (S.S.); (C.S.); (J.R.); (T.W.); (A.R.); (T.G.); (V.S.V.); (S.C.E.)
| |
Collapse
|
|
4
|
Lian G, Ng S, Stouffer GA. Can We Leave No Metal Behind? DCB vs. DES in Large Coronary Arteries. Cardiovasc Drugs Ther 2024; 38:1077-1078. [PMID: 39177719 DOI: 10.1007/s10557-024-07623-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/19/2024] [Indexed: 08/24/2024]
Affiliation(s)
- Grace Lian
- Division of Cardiology and the McAllister Heart Institute, University of North Carolina, Chapel Hill, NC, USA
| | - Spencer Ng
- Division of Cardiology and the McAllister Heart Institute, University of North Carolina, Chapel Hill, NC, USA
| | - George A Stouffer
- Division of Cardiology and the McAllister Heart Institute, University of North Carolina, Chapel Hill, NC, USA.
| |
Collapse
|