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Drug eluting balloon vs second generation

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Drug eluting balloon vs second generation

European Bifurcation Club 2013, EBC 2013 – London, UK

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Drug-eluting Balloon versus Second Generation Drug-eluting Stent for the Treatment of Restenotic Lesions Involving Coronary Bifurcations

Author: Akeem Latib, MD, San Raffaele Scientific Institute, Milan, Italy

 

CASE

  • 60 year-old male
  • Hypertension, family history of coronary artery disease, ex-smoker
  • Single-stenting with a Cypher stent was performed in a LAD/diagonal bifurcation in December 2006.

AIMS

To report clinical outcomes in pa<ents treated with drug-eluting balloon (DEB) versus second generation drug-eluting stent (DES) for in-stent restenosis (ISR) involving a bifurcation lesion.

SUMMARY

  1. The incidence of MACE was similar in the 2 groups at 2-year follow- up (32.1% in DEB group vs. 27.6% in second generation DES group) despite the fact that the DEB group had a higher EuroSCORE and higher incidence of stent-in-stent as compared to the second generation DES group.
  2. Independent predictors for MACE were stent-in-stent and true bifurcation.
  3. DEB use for first restenosis (non stent-in-stent) was associated with acceptable clinical outcomes (TLR: 2.6% at 2-year).

CONCLUSION

Our results demonstrate that DEB for bifurcation ISR may be an acceptable treatment option, especially in cases where repeat stenting has not already been used for the treatment of a previous restenosis.

 

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