Low- vs Standard Pressure Inflation of Oversized Drug-Coated Balloon for CAD Treatment

The use of oversized drug-coated balloons (DCBs) at low pressure was found to be effective in preventing late restenosis in patients with coronary artery disease (CAD), according to a study published in the Journal of Interventional Cardiology.

In this retrospective analysis, the outcomes of 273 consecutive patients with CAD who underwent treatment with DCB after successful lesion preparation at a single center in Japan between 2014 and 2018 were examined. A total of 191 lesions in 154 patients were treated using oversized DCB inflation at a low pressure (ie, <4atm; mean, 2.4±1.2 atm), and 135 lesions in 119 patients were treated with standard DCB pressure (ie, mean, 7.1±2.2 atm).

Lesions treated with low- vs standard pressure DCB were more complex (ie, with smaller reference diameter: 2.38 mm vs 2.57 mm, respectively; P =.011), and more frequently approached with rotational atherectomy (45.0% vs 28.1%, respectively; P =.003).

After propensity score matching, 125 well-matched lesion pairs were selected.  In these pairs, the cumulative incidence at 3 years of target lesion revascularization in was 4.5% and 7.0% in patients treated with low- vs standard pressure DCB, respectively (hazard ratio, 1.36; 95% CI, 0.43–4.30; P =.60). Late lumen loss (−0.00 mm vs −0.01 mm; P =.94), angiographic restenosis rates (7.4% vs 7.1%; P =1.0), and percent diameter stenosis (29.4% vs 26.0%; P =.13) were comparable in patients treated with low- vs standard pressure DCB, respectively.

Limitations of this study include its retrospective and single-center design as well as the lack of randomization.

“An in vitro study is needed to verify the results,” concluded the study authors.

Reference

Ueno K, Morita N, Kojima Y, et al. Efficacy of low-pressure inflation of oversized drug-coated balloon for coronary artery disease. J Interv Cardiol. Published online December 27, 2020. doi:10.1155/2020/6615988