Author + information
- Received January 18, 2013
- Revision received June 7, 2013
- Accepted July 3, 2013
- Published online November 1, 2013.
- Charis Costopoulos, MD∗,†,‡,
- Azeem Latib, MD∗,†,
- Toru Naganuma, MD∗,†,
- Alessandro Sticchi, MD∗,
- Filippo Figini, MD∗,
- Sandeep Basavarajaiah, MD∗,†,‡,
- Mauro Carlino, MD∗,
- Alaide Chieffo, MD∗,
- Matteo Montorfano, MD∗,
- Charbel Naim, MD∗,
- Masanori Kawaguchi, MD∗,†,
- Francesco Giannini, MD∗ and
- Antonio Colombo, MD∗,†∗ ()
- ∗Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy
- †Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy
- ‡Imperial College London, London, United Kingdom
- ↵∗Reprint requests and correspondence:
Dr. Antonio Colombo, EMO-GVM Centro Cuore Columbus, 48 Via M. Buonarroti, 20145 Milan, Italy.
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.
- diffuse coronary artery disease
- drug-eluting balloon(s)
- drug-eluting stent(s)
- target lesion revascularization
Dr. Latib is on the Medtronic Advisory Board. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received January 18, 2013.
- Revision received June 7, 2013.
- Accepted July 3, 2013.
- American College of Cardiology Foundation