Sequential use of bare-metal stents and drug-coated balloons to treat coronary artery stenosis

J Invasive Cardiol. 2012 Nov;24(11):555-9.

Abstract

Introduction: Drug-coated balloons (DCBs) are increasingly used in percutaneous coronary intervention (PCI). The sequential use of DCB and bare-metal stent (BMS) represents a novel approach and results of pilot studies have been encouraging. The aim of this study was to assess long-term outcomes of patients who received treatment with DCB and BMS and additionally study whether the order (BMS or DCB first) affected outcomes.

Methods: This is a single-center, non-randomized, prospective study of patients who underwent PCI between July 2009 and July 2011. Two groups were defined: DCB followed by BMS (DCB→BMS) or BMS followed by DCB (BMS→DCB). Our primary outcome was target lesion revascularization (TLR) at 7 months.

Results: A total of 128 patients (173 lesions) with a mean age of 67 years were included. The BMS→DCB group consisted of 53 patients (78 lesions) and the DCB→BMS group consisted of 75 patients (95 lesions). The mean follow-up was 7.4 months. The TLR rate was 4/76 (5%) in the BMS→DCB group and 3/90 (3%) in the DCB→BMS group (P=.83).

Conclusion: Our study demonstrates good results of sequential BMS and DCB use in an all-comers population. If confirmed by larger studies, this could be a valuable approach in patients with contraindications to drug-eluting stent implantation.

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary / instrumentation*
  • Angioplasty, Balloon, Coronary / methods
  • Coronary Stenosis / therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Paclitaxel*
  • Percutaneous Coronary Intervention / instrumentation
  • Percutaneous Coronary Intervention / methods
  • Prospective Studies
  • Registries
  • Retrospective Studies
  • Stents*
  • Treatment Outcome

Substances

  • Paclitaxel