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Percutaneous coronary intervention with a drug-eluting stent is the most common mode of revascularization for coronary artery disease. However, restenosis rates remain high. Non-stent-base...

Background Our study aimed to compare the efficacy of seal-wing paclitaxel-eluting balloon catheters (PEB) with iopromide-coated PEB and everolimus-eluting stents (EES) for treating bare metal stent restenosis (BMS-ISR). Methods We enrolled 64 patients with 69 BMS-ISR. The control group comprised patients from the iopromide-PEB and EES arms of a previous TIS study. The primary end-point was 12-month in-segment late lumen loss (LLL). Secondary end-points included incidence of binary in-stent restenosis and 12-month major adverse cardiac events (MACE). Results Compared to iopromide-coated PEB, seal-wing PEB was associated with significantly higher 12-month LLL (0.30 vs. 0.02 mm; p

Our purpose was to confirm the local drug delivery of a paclitaxel-eluting balloon by percutaneous intervention of single arterial segments or bifurcations of porcine coronary arteries.Eight domestic pigs were subjected to 2 x 30 s Dior balloon dilatation of the mid left anterior descending, left circumflex and proximal right coronary arteries. Bifurcation intervention was performed in six arteries. The dilated, and the distal and proximal reference segments were prepared for tissue paclitaxel concentration measurement. Tissue samples were harvested at mean 1.5, 12, 24 and 48 h after balloon dilatation and plasma samples were taken at various time points.The tissue paclitaxel concentration of the single dilated segment was at 1.5 h postdilatation 1.82+/-1.60 micromol/l, which decreased significantly to 0.73+/-0.27 (P=0.032), 0.62+/-0.34 and 0.44+/-0.31 micromol/l at 12, 24 and 48 h. The bifurcation intervention resulted in 5.10+/-1.80 micromol/l tissue paclitaxel amount in the main branch, which at 12 h had diminished to 1.41+/-1.23 micromol/l (P=0.004). The bifurcation side contained 7.00+/-4.80 micromol/l paclitaxel at 1.5 h postdilatation, which lowered to 2.72+/-0.40 micromol/l (P=0.034). The mean paclitaxel concentration of the reference segments decreased gradually from 0.84+/-0.99 to 0.34+/-0.36 micromol/l (P=0.09), 0.28+/-0.16 and 0.19+/-0.18 micromol/l tissue at 1.5, 12, 24 and 48 h postdilatation, respectively. No paclitaxel was found in the peripheral blood at any time point.Short exposure of the coronary artery to paclitaxel with a coated balloon is sufficient for the attainment of an adequate tissue concentration of paclitaxel, which is known to be efficient in inhibiting neointimal growth.

Drug eluting stents decrease the rate of restenosis, however, concerns still remains about their safety, especially in ST-segment elevation myocardial infarction (STEMI). The quest for new devices and procedures, aiming for an improved safety/efficacy balance, in STEMI is still warranted. The aim of

Drug eluting balloons currently constitute one of the therapeutic tools used in percutaneous coronary intervention (PCI) of de novo coronary lesions, mainly in bifurcations and small vessels. Nowadays, their results at a very long-term follow up are unclear. The main objective of this study was to

We report the first case of coronary aneurysm formation after paclitaxel-eluting balloon angioplasty (PEBA) used to treat a coronary restenosis following previous balloon angioplasty.

Previous studies of drug-eluting stent (DES) restenosis have shown that the morphologic pattern of in-stent restenosis (ISR) was an important predictor of outcomes after plain balloon angioplasty or repeat DES placement. However, there is no data available on the relationship between the restenosis

Coronary artery bypass graft (CABG) intervention, particularly anastomosis site intervention, is challenging for interventional cardiologists. A paclitaxel-eluting balloon catheter (SeQuent Please) is a recently-introduced device capable of delivering paclitaxel homogeneously into the targeted vessel wall. We herein report our experience with two cases. In the first case, coronary angiography showed significant stenosis at the site of anastomosis between the saphenous vein graft and the left anterior descending artery (LAD). In the second case, coronary angiography showed significant stenosis at the site of anastomosis between the left internal mammary artery and the LAD. We performed percutaneous intervention of these CABG anastomoses using paclitaxel-eluting balloon catheters, and obtained favorable angiographic and clinical outcomes.

Clinical Efficacy and Safety of Sequent Please Paclitaxel-eluting Balloon in a Real-world Multi-center Registry of South-east Asian Patients. Loon Yee Louis Teo, Rohit Khurana, Fahim Haider Jafary, Yau Wei Ooi, Julian Ko Beng Tan, Khung Keong Yeo, Tian Hai Koh, Soo Teik Lim, Than Htike Aung, Paul Ong, Hee Hwa Ho. National Heart Centre Singapore, Singapore, Singapore; Tan Tock Seng Hospital, Singapore, Singapore.