Drug coated balloons in coronary artery disease

Drug coated balloons in coronary artery disease Drug coated balloons are a novel therapeutic option in certain situations of coronary artery disease. An established use of drug coated balloon is for in-stent restenosis of both bare metal and drug eluting stents [1]. Drug coated balloon transfers antiproliferative drugs into the vessel wall during single balloon inflation. This is done by means of a lipophilic matrix. The advantage over drug eluting stent is that there is no permanent implant. Drug eluting stents have the disadvantages of neo-atherosclerosis and stent thrombosis. Even temporary implants like bioresorbable scaffolds have elevated thrombotic risk. Drug coated balloon – symbolic image Other potential indications for drug coated balloons are in small vessel disease and in those with high bleeding risk with limitation on the use of dual antiplatelet agents. The lesions are prepared by optimal angioplasty prior to delivery of the drug with a drug coated balloon. Optimal lesion preparation may be assessed by angiography, intravascular imaging or physiology. If lesions cannot be prepared adequately with balloon dilatation alone, ablative procedures like rotablation, laser or orbital atherectomy may be needed. Stent implantation may be needed if the results are suboptimal after lesion preparation. These include dissection and significant recoil. Sometimes stenting may be required as a bailout after the application of a drug coated balloon. Bare metal stents may b...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Coronary Interventions Source Type: blogs