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Drug coated balloon

Jun Zhang, Xiao Zhang, Jin-Ping Zhang, Ju Han
The optimal treatment for patients with chronic symptomatic middle cerebral artery (MCA) total occlusion is not well established. In addition to medical therapy, vessel recanalisation with stenting has shown much promise, especially for patients with recurrent ischemic symptoms. Nevertheless, the incidence of symptomatic in-stent restenosis (ISR) is high, and is associated with an unfavorable prognosis. Drug coated balloons (DCBs) have been proven to be effective in treating and preventing ISR. However, the feasibility of DCBs for de novo intracranial atherothrombotic stenosis has not been previously described, especially for total occlusion lesions...
March 15, 2018: BMJ Case Reports
Jun Shiraishi, Nariko Koshi, Yuki Matsubara, Tetsuro Nishimura, Akira Shikuma, Keisuke Shoji, Daisuke Ito, Masayoshi Kimura, Eigo Kishita, Yusuke Nakagawa, Masayuki Hyogo, Takahisa Sawada
BACKGROUND: Experiences of rotational atherectomy (RA) followed by drug-coated balloon (DCB) dilation alone (RA/DCB) for de novo coronary artery lesion have been limited. CASE SERIES: Case 1 (65 year-old male) with silent myocardial ischemia and hemodialysis had old anterior myocardial infarction and intact LM/LCx, and underwent RA/DCB against a diffuse calcified lesion in the proximal LAD and a tandem lesion in the proximal RCA. Case 2 (88 year-old female) with post-infarction unstable angina had severe thrombocytopenia and anemia due to myelodysplastic syndrome (platelet 6000/μL, hemoglobin 8...
February 12, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Benoît Merat, Matthias Waliszewski, Guillaume Dillinger, Patrick Henry, Georgios Sideris
OBJECTIVES: The objective of this study was to assess the 12-month clinical outcomes in patients with drug-eluting stent in-stent restenosis (DES-ISR) who were either pre-dilated with non-compliant balloons (NCBA) and with additional scoring balloons (NCBA + SBA) prior to drug coated balloon (DCB) angioplasty. METHODS: This monocentric, retrospective study included patients with DES-ISR who were routinely treated over a 2-year time span. Patients with stable angina and documented ischemia or selected forms of unstable angina due to a culprit DES-ISR lesion were analyzed...
March 11, 2018: Journal of Interventional Cardiology
Nicole Gilgen, Ahmed Farah, Bruno Scheller, Marc-Alexander Ohlow, Norman Mangner, Daniel Weilenmann, Jochen Wöhrle, Peiman Jamshidi, Gregor Leibundgut, Sven Möbius-Winkler, Robert Zweiker, Florian Krackhardt, Christian Butter, Leonhard Bruch, Christoph Kaiser, Andreas Hoffmann, Peter Rickenbacher, Christian Mueller, Frank-Peter Stephan, Michael Coslovsky, Raban Jeger
BACKGROUND: The treatment of coronary small vessel disease (SVD) remains an unresolved issue. Drug-eluting stents (DES) have limited efficacy due to increased rates of instent-restenosis, mainly caused by late lumen loss. Drug-coated balloons (DCB) are a promising technique since native vessels remain structurally unchanged. METHODS: BASKET-SMALL 2 is a multicenter, randomized, controlled, non-inferiority trial of DCB vs. DES in native SVD for clinical endpoints...
March 11, 2018: Clinical Cardiology
Mehdi H Shishehbor, Michael R Jaff, Joshua A Beckman, Sanjay Misra, Peter A Schneider, Robert Lookstein, Vikram S Kashyap, Herbert D Aronow, William Schuyler Jones, Christopher J White
On Wednesday, November 1, 2017, the Centers for Medicare and Medicaid Services (CMS) made a public decision to end the transitional pass-through add-on payment for drug-coated balloons beginning January 1, 2018, without creating a new ambulatory payment classification rate for these devices. In this Viewpoint, the authors highlight the disconnect between the CMS's decision not to create a new ambulatory payment classification category for drug-coated balloons despite demonstrated clinical superiority. The authors believe this decision is more in line with a rigid fee-for-service payment system than a value-based system that encourages quality over quantity, and disadvantages both the elderly and the poor...
March 12, 2018: JACC. Cardiovascular Interventions
Sarifuddin, Prashanta Kumar Mandal
Angioplasty with drug-coated balloons (DCBs) using excipients as drug carriers is emerging as a potentially viable strategy demonstrating clinical efficacy and proposing additional compliance for the treatment of obstructive vascular diseases. An attempt is made to develop an improved computational model where attention has been paid to the effect of interstitial flow, that is, plasma convection and internalization of bound drug. The present model is capable of capturing the phenomena of the transport of free drug and its retention, and also the internalization of drug in the process of endocytosis to atherosclerotic vessel of heterogeneous tissue composition comprising of healthy tissue, as well as regions of fibrous cap, fibro-fatty, calcified and necrotic core lesions...
March 5, 2018: Cardiovascular Engineering and Technology
Emily A Turner, Marzieh K Atigh, Megan M Erwin, Uwe Christians, Saami K Yazdani
Drug coated balloons (DCB) are becoming the standard-care treatment for peripheral arterial disease (PAD). DCB use excipients to transfer and retain anti-proliferative drugs, such as paclitaxel. Excipients thus play a vital role in the design and function of DCB, however methods to coat balloons with excipients and anti-proliferative drugs remain unknown. The goal of this study was to thus develop an approach to coat and evaluate DCB for various excipients. An air sprayer method was developed to deposit paclitaxel and various excipients onto non-coated commercially available angioplasty balloons...
March 1, 2018: Cardiovascular Engineering and Technology
Dimitrios Venetsanos, Sofia Sederholm Lawesson, Georgios Panayi, Tim Tödt, Ulf Berglund, Eva Swahn, Joakim Alfredsson
BACKGROUND: Studies comparing drug coated balloons (DCB) with new generation drug-eluting stents (nDES) for the treatment of de novo coronary artery lesions are lacking. METHODS: From 2009 to 2016, DCB or nDES used for treatment of de novo coronary lesions at our institution were included, in total 1,197 DEB and 6,458 nDES. We evaluated target lesions restenosis (TLR) and definite target lesion thrombosis (TLT). Propensity score modeling were utilized to study adjusted associations between treatment and outcomes...
February 26, 2018: Catheterization and Cardiovascular Interventions
Jin-Zan Cai, Yong-Xiang Zhu, Xin-Yu Wang, Christos V Bourantas, Javaid Iqbal, Hao Zhu, Paul Cummins, Sheng-Jie Dong, Anthony Mathur, Yao-Jun Zhang
OBJECTIVE: The study sought to compare angiographic and clinical outcomes of new-generation drug-eluting stents (DES) versus drug-coated balloon (DCB) in patients with coronary in-stent restenosis (ISR). DESIGN: Meta-analysis using data from randomised trial found by searches on PubMed, the Cochrane Library, and websites of major cardiovascular congresses. SETTING: Only randomised trials comparing DES with DCB were included...
February 22, 2018: BMJ Open
Hsuan-Li Huang, Hsin-Hua Chou, I-Chih Chen, Chien-An Hsieh, Shih-Jung Jang, I-Shiang Tzeng, Yu-Lin Ko
BACKGROUND: Pattern of DCB restenosis and associated outcomes in facing complex femoropopliteal lesions remain uncertain. METHODS: Data were retrospectively collected from dual centers in Taiwan on patients who underwent treatment with DCBs for femoropopliteal lesions between 2013 and 2016. The restenosis pattern was categorized by the index-treated length. Clinical outcomes and time to DCB restenosis were retrospectively analyzed. Cox proportional hazards model identified restenosis predictors...
February 17, 2018: International Journal of Cardiology
Ayako Harima, Akinori Sairaku, Ichiro Inoue, Kenji Nishioka, Toshiharu Oka, Yasuharu Nakama, Kazuoki Dai, Kuniomi Ohi, Haruki Hashimoto, Yasuki Kihara
OBJECTIVES: We aimed to test a novel stent-less revascularization strategy using a combination of excimer laser coronary angioplasty (ELCA) and drug-coated balloon (DCB) for patients with acute coronary syndrome (ACS). BACKGROUND: Percutaneous coronary intervention with drug eluting stents is a standard invasive treatment for ACS. Some unsolved issues however remain, such as stent thrombosis and bleeding risks associated with dual antiplatelet therapy. METHODS: Consecutive ACS patients were planned to receive either a DCB application following ELCA without a stent implantation or conventional revascularization with a coronary stent...
February 20, 2018: Journal of Interventional Cardiology
Bernardo Cortese, Gaetano DI Palma, Roberto Latini
Drug-coated balloons (DCB) have been developed in recent years to overcome some of the DES limitations. There is an established indication for the use of DCB in the treatment of in-stent restenosis and they are also variably used in various setting, in particular small coronary vessels and bifurcations. Until 2016, all DCBs available in Europe eluted paclitaxel, a highly lipophilic drug with narrow therapeutic window. In April 2016 a new sirolimus-coated balloon (SCB, Magic Touch®, Envision Scientific PVT, India), obtained the CE Mark...
February 19, 2018: Minerva Cardioangiologica
YaBing Wang, Yan Ma, Peng Gao, Yanfei Chen, Bin Yang, Liqun Jiao
No abstract text is available yet for this article.
February 9, 2018: JACC. Cardiovascular Interventions
Yiu Tung Anthony Wong, Do-Yoon Kang, Jin Bae Lee, Seung-Woon Rha, Young Joon Hong, Eun-Seok Shin, Sung-Ho Her, Chang Wook Nam, Woo-Young Chung, Moo Hyun Kim, Cheol Hyun Lee, Pil Hyung Lee, Jung-Min Ahn, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Duk-Woo Park, Seung-Jung Park
BACKGROUND: This study sought to evaluate the optimal treatment for in-stent restenosis (ISR) of drug-eluting stents (DESs). METHODS: This is a prospective, multicenter, open-label, randomized study comparing the use of drug-eluting balloon (DEB) versus second-generation everolimus-eluting stent for the treatment of DES ISR. The primary end point was in-segment late loss at 9-month routine angiographic follow-up. RESULTS: A total of 172 patients were enrolled, and 74 (43...
March 2018: American Heart Journal
Charles Nicolais, Vladimir Lakhter, Hafeez Ul Hassan Virk, Partha Sardar, Chirag Bavishi, Brian O'Murchu, Saurav Chatterjee
PURPOSE OF REVIEW: In-stent restenosis (ISR) is a complex disease process that became apparent shortly after the introduction of stents into clinical practice. This review seeks to define in-stent restenosis (ISR) as well as to summarize the major treatment options that have been developed and studied over the past two decades. RECENT FINDINGS: Recent developments in drug-coated balloons and bioresorbable vascular scaffolds have added new potential treatments for ISR...
February 12, 2018: Current Cardiology Reports
Bernardo Cortese, Fabrizio D'Ascenzo, Raffaela Fetiveau, Vruyr Balian, Simonetta Blengino, Massimo Fineschi, Renata Rogacka, Corrado Lettieri, Andrea Pavei, Maurizio D'Amico, Arnaldo Poli, Gaetano Di Palma, Roberto A Latini, Pedro S Orrego, Romano Seregni
AIMS: Drug-coated balloons (DCBs) are a recognized alternative to stents for the treatment of in-stent restenosis (ISR), and there is some initial clinical evidence about their efficacy for the treatment of small coronary vessels. Newer-generation DCBs were developed to overcome the reduced deliverability of the previous generation, also warranting a more effective drug delivery to vessel wall. However, the vast majority of new-generation DCBs still lack of reliability due to paucity of clinical data...
February 9, 2018: Journal of Cardiovascular Medicine
Dimitrios Barbalias, Georgios Lappas, Panagiota Ravazoula, Despoina Liourdi, Iason Kyriazis, Evangelos N Liatsikos, Panagiotis Kallidonis
INTRODUCTION: Urethral strictures are a common urological problem which could require complex reconstructive procedures. Urethral dilation represents a frequent practiced invervention associated with high recurrence rates. Drug-coated balloons with cytostatic drugs have been successfully used for the prevention of vascular restenosis after balloon dilation. In an attempt to reduce the restenosis rates of urethral dilation, these balloons could be used in the urethra. Nevertheless, the urothelium is different than the endothelium and these drugs may not be distributed to the outer layers of the urethra...
January 30, 2018: Journal of Endourology
X Yu, F S Ji, F Xu, W D Zhang, X Y Wang, D Lu, T Xu
Objective: To evaluate the efficacy of paclitaxel-coated balloon for de novo coronary lesions with diameters ≥ 2.8 mm. Methods: This prospective study included 215 consecutive patients with 238 de novo lesions, who received paclitaxel-coated balloon angioplasty in Beijing Hospital from May 2014 to June 2016. According to the reference vessel diameter, the patients were divided into large vessel disease (LVD) group (reference vessel diameter≥2.8 mm, 85 patients and 90 lesions) and small vessel disease (SVD) group (reference vessel diameter<2...
January 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
Mostafa Elwany, Gaetano Di Palma, Bernardo Cortese
Coronary lesions at bifurcation sites are frequent and still remain a challenging subset for the interventional cardiologist. Although in the last years the provisional stenting technique has shown more consistent results, coronary bifurcation interventions still share a worse procedural success rate and increased rates of mid- and long-term cardiac events. Most of the dedicated devices proposed in the last few years have failed to show improved results when compared with standard devices. The broader use of imaging techniques, such as intravascular ultrasound and optical coherence tomography, lead to a better understanding of the real anatomy of bifurcations and has shown to be a great tool for percutaneous coronary intervention optimization...
January 26, 2018: Future Cardiology
Chun-Meng Li, Tao Shang, Lu Tian, Hong-Kun Zhang
BACKGROUND This study aimed to evaluate the early and mid-term outcomes of drug-coated balloon (DCB) use in patients who underwent intervention for transplant renal artery stenosis (TRAS). MATERIAL AND METHODS We retrospectively reviewed the records of TRAS patients who received endovascular therapy with DCB in our institution from March 2016 to January 2017. Statistical analysis of pre-/postoperative levels of serum creatinine (Scr), systolic blood pressure (SBP), and renal artery peak systolic velocities (PSV) were performed...
January 26, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
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