Drug eluting stents (DES) have improved considerably over the years, reducing the initial indices of instent restenosis (ISR) by roughly 5-10% a year in USA. However, DES failure might lead to neointimal hyperplasia and neoatherosclerosis, which increases the chance of developing chronic and acute coronary syndromes. Drug coated balloons (DCB), which administer anti-proliferative agents with…
Treatment of Femoropopliteal Lesions with Low-Dose vs. High-Dose Drug-Coated Balloons
The use of drug-covered balloons (DCBs) has increased significantly for the endovascular treatment of femoropopliteal arterial disease. Previous studies on first-generation high-dose DCB (HD-DCB) have validated its benefits, thus supporting its recommendation in current clinical guidelines. However, there have been reports of adverse effects associated with paclitaxel and its excipients. Second-generation, lower-dose DCBs (LD-DCB) have…
Outcomes of the Use of Drug Coated Balloons in the Treatment of De Novo Coronary Lesions
Drug coated balloon (DCB) angioplasty offers a novel strategy for treating coronary artery disease. Studies assessing this strategy have shown clinical outcomes comparable to drug-eluting stents’ (DES) in patients with in-stent restenosis and de novo disease in small vessels. However, evidence for the use of DCB in large coronary vessels is limited. This observational, retrospective study DCB…
Drug-Coated Balloons (DCB): Sirolimus vs. Paclitaxel in De Novo Lesions in Small Vessels
The use of drug-coated balloons (DCB) offers the advantage of avoiding permanent stent implants, thus reducing the incidence of in-stent restenosis (ISR), neoatherosclerosis, and late in-stent thrombosis. Additionally, the use of DCB reduces the duration of dual antiplatelet therapy. Current evidence supports the use of DCB for ISR treatment (Class I) compared with drug-eluting stents…
Use of Drug-Coated Balloons in De Novo Lesions in Large Coronary Vessels
Drug-coated balloon (DCB) angioplasty is emerging as a novel treatment for coronary artery disease. Studies evaluating this strategy have demonstrated clinically non-inferior outcomes compared with those of drug-eluting stent (DES) implantation in patients with in-stent restenosis and de novo disease in small vessels. However, evidence for the use of DCBs in large coronary vessels is…
Drug Coated Balloons: Link between Femoropopliteal Lesion Calcification Grade and Clinical Outcomes
At present, the use of drug coated balloons (DCB) in femoropopliteal territory is more and more frequent. However, when it comes to treating moderate to severe calcification, the evidence is still limited. Using a peripheral artery calcification scoring system (PACSS) has been associated to clinical outcomes after DCB angioplasty for femoropopliteal lesions. The system categorizes…
PICCOLETO-II: Drug-Coated Balloons in Small Vessels
Use of drug-coated balloons vs. drug-eluting stents in small caliber vessels. The constant advancements in coronary device technology have significantly reduced complication rates (such as that of restenosis). However, there are gaps where a high number of undesirable events prevail, such as small vessel disease (SVD), for which, in previous studies up, the rate of…
Should We Use Drug Coated Balloons in Patients with Multivessel Disease?
Recent studies have shown that a drug coated balloons (DCB) based approach resulted non inferior when compared against drug eluting stents (DES) only approach in patients with instent restenosis and de novo lesions in small vessel disease. So far, two international consensuses have reported the use of DCB is feasible and safe to treat native…
IN.PACT Global: Follow Up of Real-Life Patient in Femoropopliteal Territory
Drug coated balloons (DCB) emerged as an innovative treatment approximately 10 years ago. Since then, numerous randomized studies have shown their effectiveness and benefit in femoropopliteal territory, and even though the use of paclitaxel coated balloons has been called into question, a retrospective study including 168,553 patients was able to show paclitaxel coated balloons were…
Drug-Coated Balloons in Critical Ischemia: The Paradigm of Randomized Evidence vs. Logbooks
This research, which included thousands of patients treated for chronic inferior limb ischemia with drug-coated balloons, did not show an association between said devices and the increased mortality observed in some randomized trials. The long-term evidence from plenty of real-world patients contradicts what has been shown in randomized trials, leaving an information gap. Endovascular revascularization…
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