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

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...

TCT 2024 | Use of Drug-Coated Balloons for Side Branch Treatment in Provisional Stenting

In some cases, treating coronary bifurcations with provisional stenting requires side branch stenting, which may lead to suboptimal outcomes. Drug-coated balloons (DCBs) have emerged...

TCT 2024 | Use of Artificial Intelligence for Patients with Suspected Coronary Artery Disease

The current approach to chest pain mainly focuses on symptom characteristics, conducting functional tests for ischemia assessment. However, several randomized clinical trials have shown...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

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 | TRISCEND II

This randomized study included 400 patients; 267 were treated with EVOQUE valve and 133 with optimal medical treatment (OMT). After one-year follow-up, there were no...

TCT 2024 – ACCESS-TAVI: Comparing Percutaneous Access Closure Strategies After TAVI

Vascular access complications following transcatheter aortic valve implantation (TAVI) remain common. However, few studies compare vascular access closure methods.  Based on the CHOICE-CLOSURE and MASH...