Drug coated balloons and their role in bifurcation coronary angioplasty: appraisal of the current evidence and future directions. (2nd October 2020)

• Record Type: Journal Article
• Authors: Rathore, Sudhir; Tehrani, Shana; Prvulovic, Deiti; Araya, Mario; Lefèvre, Thierry; Banning, Adrian P; Burzotta, Francesco; Rigatelli, Gianluca; Gutierrez-Chico, Juan Luis; Bonaventura, Klaus; Chevalier, Bernard; Kinoshita, Yoshihisa; Sikic, Jozica; Alfonso, Fernando; Louvard, Yves; Stankovic, Goran
• Is Part Of: Expert review of medical devices. Volume 17:Number 10(2020)
• Page Start: 1021
• Page End: 1033
• Publication Date: 2020-10-02
• Subjects: Drug coated balloon -- coronary bifurcation lesions -- mace -- outcomes -- future directions -- target lesion revascularization -- lesion preparation; Medical instruments and apparatus -- Periodicals; 610.28
• DOI: 10.1080/17434440.2020.1831385
• Languages: English
• ISSNs: 1743-4440

Abstract

ABSTRACT: Introduction: Coronary Bifurcation lesions are technically more challenging and Bifurcation percutaneous coronary intervention (PCI) remains a challenge with unpredictable and sub-optimal clinical and angiographic results. Drug-Coated Balloons (DCB) are emerging devices in the field of coronary intervention with promising results that may overcome some of drug eluting stents limitations and may have potential advantages in complex bifurcation PCI. Areas covered: We have performed a re-appraisal about the issues with current bifurcation PCI techniques and the use of DCB in the treatment of Bifurcation lesions. Several studies performed utilizing DCB are described and critically appraised. Over the recent years, there have been tremendous developments in the DCB technology, lesion preparation, clinical experience, and clinical data during bifurcation PCI. The current review describes the advances in the DCB technology, pharmacokinetics, role of excipients, and optimization of the technique. Special emphasis in lesion preparation and potential pathway of using DCB in bifurcation PCI is proposed. Expert opinion: Although different proof of concept and pilot studies have shown promising results in treatment of bifurcation lesions with DCB, larger randomized trials and/or international consensus papers are required to enable worldwide translation of this idea to clinical practice.