Efficiency of Drug Coated Balloon after Directional Coronary Artherectomy for Coronary Bifurcation Lesions

European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain LM SESSION Efficiancy of Drug Coated Balloon after Directional Coronary Artherectomy for Coronary Bifurcation Lesions - DCA/DCB Registry -As an Option of Stent-less PCI Strategy for Bifurcation Lesions- Author: Shunsuke Kitani, MD, Tokeidai Memorial Hospital, Japan BACKGROUND The optimal strategy for bifurcation lesions still remains controversial even in DES era. DCA-alone had high restenosis rate (20-50%) and TLR rate (15-37%) due to excessive intimal hyperplasia after DCA. Combined DCA and DES for bifurcation lesions reduced restenosis rates (Maiin V 1.1%, SB 3.4%). OBJECTIVES To evaluate the efficacy and safety of DCA/DCB forbifurcation lesions. CONCLUSION DCA/DCB for bifurcation lesions provided good clinical outcomes, minimizing side branch damage. DCA/DCB can be one of the good options as stent-less PCI strategy for bifurcation lesions, especially LMT.

Read more about the article Use of DES and DCB in LM Bifuration Lesion

Use of DES and DCB in LM Bifuration Lesion

European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain TIPS AND TRICKS IN BIFURCATION PCI - THE SYNERGY BETWEEN EBC AND ASIA Use of DES and DCB in LM Bifuration Lesion Author: Zhanying Han, MD, First Affiliated Hospital of Zhengzhou University, China BACKGROUND Although several stenting techniques are available for the treatment of de novo coronary bifurcation lesions. The treatment of coronary artery bifurcation still represents a challenge for interventional cardiologist. over the past years, different studies have proposed and analysed the use of drug-coated balloon (DCB) in the treatment of coronary artery bifurcation lesions as an alternative treatment. CLINICAL CHARACTERISTICS Zhang Q Female 76years Paroxysmal chest tightness for 10 years Agravated for 20 days Risk factor: Diabetes 1 year, Angiitis 30 years TAKE HOME MESSAGES For calcified LM bifurcation lesion, intravascular imaging is strongly recommended to help to determine the PCI strategy. Rotablation is effective to modify the calcified plaque in both MV and SB bifurcation lesion DCB may supply an alternative treatment for bifurcation lesions, thus maybe decrease the stent numbers , thrombosis and restenosis risk of side branch.

Read more about the article DCB in the treatment of bifurcations: Scenarios for future studies

DCB in the treatment of bifurcations: Scenarios for future studies

European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain BIFURCATION AND DRUG ELUTING BALLOONS - VOTING DCB in the treatment of bifurcations: Scenarios for future studies Author: Juan Luis Gutierrez Chico, MD, Cardiac Care - Cardiovascular Heart Centre Marbella, Spain 4 POSSIBLE SCENARIOS 1st scenario: NORDIC-III-like 2nd scenario: BBC-ONE-like 3rd scenario: rePOT 4th scenario: rePOT-DOT

Existing data on drug coated balloons and coronary bifurcation treatment

European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain BIFURCATION AND DRUG ELUTING BALLOONS - VOTING Existing data on drug coated balloons and coronary bifurcation treatment Author: Mario Araya, MD, Clinica Alemana De Santiago/ Thorax National Institute, Chile 4 STRATEGIES TESTED DCB with BMS DCB with DES DCB-only strategy DCB in bifurcaAon restenosis WHERE DO WE STAND Trials of DCB in bifurcaAon treatment use different protocols and devices, in small trials. No POT, low kissing. We need more data. Only paclitaxel-coated balloon have been reported. In general, the use of pDCB appears to be effective and safe in SB. The use of pDCB + BMS is inferior to conventional DES treatment The use of pDCB + DES (Everolimus) show excellent results in small registries . Only-DCB strategy is feasible and safe. In Restenosis of bifurcation, including LM, DCB tx show promising results compare to DES

Existing Drug Coated Balloon Technology

European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain BIFURCATION AND DRUG ELUTING BALLOONS - VOTING Existing Drug Coated Balloon Technology Author: Deiti Prvulovic, MD, PhD, KBC Rijeka, Croatia CONCLUSION DCB technology evolve toward the development of new delivery methods and new drugs for the broader adoption of these technologies DCB must be tested in RCT with sufficient statistical power to detect at least noninferiority against new generation DES with hard clinical endpoints