Can Drug Coated Balloon Be a Valid Option for Small Vessels?

One of the challenges of percutaneous coronary interventions (PCI) are <2.5 mm vessels, since complications and restenosis complications rate are higher than with >3.0 mm vessels.  

balones liberadores de droga

Drug Coated Balloons (DCB) can be a useful tool, but their efficacy and safety [vs. plain old balloon angioplasty] remains unclear. 

PEPCAD China SVD is a prospective and multicenter study that looked at 268 patients with severe lesions in vessels measuring 2.0 to 2.75 mm in diameter and <30 mm length. 181 of these patients (67.5%) received DCB and 87 plain old balloon angioplasty (POBA) in de novo lesions.

Primary end point was late lumen loss (LLL) at 9 months.

The groups were similar, mean age was 63, 72% were men, 70% had hypertension, 35% diabetes, 43% had prior PCI and very few had received myocardial revascularization surgery (CABG).

There were no differences in clinical symptoms leading to PCI. 

Neither were there differences in vessel diameter, obstruction degree, compromised artery, or the need for stenting, which was quite low. 

Read also: Left Main Coronary Artery Percutaneous Coronary Intervention: Evolution and Results over Time.

Primary end point resulted in favor of DCB (0.10 ± 0.33mm vs. 0.25 ± 0.38mm p= 0.0037), but there was no difference in MACE, MI related to the treated vessel, ischemia or thrombosis driven TLR.

Conclusion

Treating de novo lesions in small vessels with DCB was superior to POBA with lower late lumen loss at 9 months. Clinical events rate was comparable between devices. 

Dr. Carlos Fava - Consejo Editorial SOLACI

Dr. Carlos Fava.
Member of the Editorial Board of SOLACI.org.

Original Title: Drug‐coated balloon for the treatment of small vessel disease: 9 months of angiographic results and 12 months of clinical outcomes of the PEPCAD China SVD study.

Reference: Juying Qian MD, et al. Catheter Cardiovasc Interv. 2023;101:33–43.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

More articles by this author

Coronary Artery Disease in Aortic Stenosis: CABG + SAVR vs. TAVR + PCI: Data from Spanish Centers

Multiple randomized studies have shown comparable or superior efficacy of transcatheter aortic valve replacement (TAVR) vs. coronary artery bypass graft (CABG).  However, many of...

Evolution of Small Balloon-Expandable Valves

Small aortic rings (20 mm) have posed a significant challenge for both surgery and transcatheter aortic valve implantation (TAVI) due to their association with an...

TCT 2024 | FAVOR III EUROPA

The study FAVOR III EUROPA, a randomized trial, included 2,000 patients with chronic coronary syndrome, or stabilized acute coronary syndrome, and intermediate lesions. 1,008...

TCT 2024 – ECLIPSE: Randomized Study of Orbital Atherectomy vs Conventional PCI in Severely Calcified Lesions

Coronary calcification is associated with stent under-expansion and increased risk of both early and late adverse events. Atherectomy is an essential tool for uncrossable...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

Severe Tricuspid Regurgitation: Surgical vs. Transcatheter Edge-to-Edge Repair

While highly prevalent, tricuspid regurgitation is a notably undertreated valvulopathy. Its progression has been associated with higher mortality and significant disability. According to the...

ACCESS-TAVI: Comparing Post TAVR Vascular Closure Devices

Transcatheter aortic valve replacement (TAVR) is a well-established option to treat elderly patients with severe symptomatic aortic valve stenosis. Technical advances and device development...

Endovascular Treatment of Iliofemoral Disease for the Improvement of Heart Failure with Preserved Ejection Fraction

Peripheral artery disease (PAD) is a significant risk factor in the development of difficult-to-treat conditions, such as heart failure with preserved ejection fraction (HFpEF)....