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Experience with Drug-Eluted Balloons: Insights from a Tertiary Care Centre
Session:
SESSÃO DE POSTERS 32 - DOENÇAS CARDIOVASCULARES - EAM COM SUPRADESNIVELAMENTO DO SEGMENTO ST
Speaker:
João Reis Sabido
Congress:
CPC 2025
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.2 Coronary Intervention
Session Type:
Cartazes
FP Number:
---
Authors:
João Reis Sabido; Miguel Azaredo Raposo; Miguel Nobre Menezes; Cláudia Moreira Jorge; João Silva Marques; Pedro Carrilho Ferreira; Tiago Rodrigues; Ana Rita Francisco; José António Duarte; José Marques da Costa; Pedro Cardoso; Fausto J. Pinto
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong><span style="font-family:Calibri,sans-serif">Introduction</span></strong><span style="font-family:Calibri,sans-serif">: Drug-eluting balloons (DEBs) are semi-compliant catheters coated with antiproliferative drugs, delivered to vessel walls during inflation. They are effective for in-stent restenosis and show promise in small vessel disease, bifurcation lesions, and high bleeding-risk patients.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><span style="font-family:Calibri,sans-serif"><strong>Purpose</strong>: To characterize the experience with DEBs at a tertiary centre.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong><span style="font-family:Calibri,sans-serif">Methods</span></strong><span style="font-family:Calibri,sans-serif">: Observational, single-center study on percutaneous coronary intervention (PCI) with DEB. </span><span style="font-family:Calibri,sans-serif">Clinical and procedural data were prospectively recorded in hospital clinical records from May 2011 to December 2023.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong><span style="font-family:Calibri,sans-serif">Results</span></strong><span style="font-family:Calibri,sans-serif">: A total of 266 PCIs using DEBs were performed. DEB use increased from 0.09% of angioplasties in 2011 to 5.71% in 2023 (CAGR 41%). Among patients, 74.4% were male, and the mean age was 68.1 years. Key comorbidities included smoking (39.8%), diabetes (55.3%), hypertension (86.1%), hypercholesterolemia (80.8%), and chronic kidney disease (37.2%). Prior interventions included PCI (57.1%) and surgical revascularization (4.5%). Angiographies were performed due to chronic coronary syndrome (51.5%), NSTEMI (29.7%), unstable angina (10.9%), and STEMI (6.4%). The main indication for DEB use was stent restenosis (53.1%), followed by small vessel disease (26.3%) and bifurcation lesions (12.2%). DEBs were used in the left anterior descending artery (38%), right coronary artery (18.8%), and circumflex artery (15%). Paclitaxel DEBs were more prevalent, representing 98.5% of all (PANTERA-LUX 32.3%, IN-PACT Falcon 49.6%, SeQuent Please 8.3%, PREVAIL 8.3%). Sirolimus DEBs were used in 1.5% (SELUTION SRL). The mean diameters and lengths were 2.7 mm and 21 mm, respectively. Imaging was performed in 16.1% of interventions (IVUS 10.5%, OCT 5.6%). Lesion preparation involved balloon angioplasty in 85.3% and calcium-modifying techniques in 13.2% (cutting balloon 3.8%, lithotripsy 4.5%, and rotational atherectomy 1.1%). TIMI 3 flow was achieved in 97.4%. Rescue drug-eluting stents were used in 14.7% for significant residual lesions or dissection. At discharge, 30.8% were on DAPT (66.2% aspirin/clopidogrel) for a median of 12 months. Final therapy included aspirin (62.9%), clopidogrel (21%), and DOACs (13.3%). Over 33 months of follow-up, 16.9% had repeat angiography (7.6% target lesion failure: 6.8% restenosis, 0.8% thrombosis). Heart failure admissions were 7.5%, and mortality was 22.9%, with 15% due to cardiovascular causes.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong><span style="font-family:Calibri,sans-serif">Conclusions</span></strong><span style="font-family:Calibri,sans-serif">: DEBs show high success, safety, and efficacy in real-world use, with low restenosis and thrombosis rates.</span></span></span></span></p>
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