Coronary Lithotripsy as Elective or Bail-Out Strategy After Rotational Atherectomy in the Rota-Shock Registry
Debulking lesions with severe coronary artery calcification (CAC) is highly recommended to obtain good procedural and long-term success. Utilization and performance of coronary intravascular lithotripsy (IVL) after rotational atherectomy (RA) has not been thoroughly studied. This study aimed to evaluate the efficacy and safety of IVL with the Shockwave Coronary Rx Lithotripsy System in lesions with severe CAC as an elective or bail-out strategy after RA. This observational, prospective, single-arm, multicenter, international, open-label Rota-Shock registry included patients with symptomatic coronary artery disease and lesions with severe CAC who underwent percutaneous coronary intervention, including lesion preparation with RA and IVL, at 23 high-volume centers. The results of this trial suggest that IVL after RA in lesions with severe CAC is a viable and safe option, with a very low incidence of complications, whether used as an elective or bail-out strategy.
How to perform a successful drug‐coated balloon angioplasty? Tips and tricks
I palloncini rivestiti di farmaco (DCB) sono un’alternativa promettente agli stent grazie alla loro capacità di rilasciare farmaci antiproliferativi senza lasciare un impianto permanente nel corpo. Tuttavia, nonostante l’uso crescente del DCB, ci sono ancora sfide nell’utilizzare questa tecnologia in modo efficace. Ad esempio, ci sono differenze nel processo di angioplastica quando si utilizza il DCB rispetto agli stent a rilascio di farmaco (DES). Pertanto, questo articolo ha fornito suggerimenti e trucchi per gli operatori che sono nuovi all’uso di DCB o desiderano migliorare le proprie tecniche. Inoltre, questo documento includeva casi di studio e un algoritmo per l’utilizzo del DCB nel trattamento della restenosi in-stent (ISR) e delle lesioni de novo.
A Prospective Randomized Trial Comparing Sirolimus-Coated Balloon With Paclitaxel-Coated Balloon in De Novo Small Vessels
There are currently no available studies that directly compare sirolimus-coated balloons (SCBs) to paclitaxel-coated balloons (PCBs) for the treatment of de novo small vessel disease (SVD). However, this prospective, multicenter, noninferiority trial did attempt to compare the two treatments. The study, which randomized 121 patients (129 SVD lesions) to receive either an SCB or a PCB, found that the SCB failed to demonstrate noninferiority for angiographic net lumen gain at 6 months compared to the PCB.
Long-term benefits of drug-coated balloons for coronary artery revascularization
Several studies have also shown that DES is associated with a higher risk of target vessel revascularization compared to CABG after long-term follow-up. However, drug-coated balloons (DCB) have been shown to provide significant clinical benefits in the treatment of in-stent restenosis, diffuse coronary artery disease, and small coronary artery lesions. Therefore, this review aimed to highlight the limitations of DES and showcase the potential advantages of using PCI with DCB for long-term outcomes, potentially demonstrating its non-inferiority to CABG.