Conference Coverage

VIDEO: Drug-coated balloons offer in-stent restenosis option




SAN FRANCISCO – Drug-coated balloons have become a widely used option in Europe for treating coronary in-stent restenosis, and the scoring-balloon pretreatment tested in ISAR-DESIRE 4 appeared to boost the efficacy of a drug-coated balloon in a clinically meaningful way, Dr. Marco Valgimigli said in an interview at the Transcatheter Cardiovascular Therapeutics annual meeting.

When patients develop restenosis within a coronary stent, many times it’s because the stent was not properly expanded during initial placement. An advantage to a drug-coated balloon is that it pairs well with therapeutic reexpansion of the existing stent to its proper, fully open position.

In addition, this approach spares the patient from receiving a second stent inside the first stent, said Dr. Valgimigli, an interventional cardiologist at Inselspital in Bern, Switzerland.

Often when patients develop in-stent restenosis, it tends to keep recurring. And when that happens, eventually the only remaining option for effective revascularization of the patient’s coronary arteries is coronary bypass surgery.

Pretreating in-stent restenosis with a scoring balloon prior to treatment with a drug-coated balloon improved efficacy in the ISAR-DESIRE 4 trial by a modest amount. But if this treatment strategy can successfully defer or obviate just a few cases that might otherwise require coronary bypass surgery, then using the scoring balloon is a reasonable approach, Dr. Valgimigli said at the meeting, sponsored by the Cardiovascular Research Foundation.

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