Background Since introduction in 2004, Drug Coated Balloons (DCB) have played key role in management of in-stent restenosis (ISR) and improving cardiovascular outcomes in percutaneous coronary intervention (PCI).1 Current European Society of Cardiology (ESC) guidelines recommend use of DCB for ISR (Class 1A).2 However, there is limited understanding in their role for small vessel and bifurcation disease angioplasty. Methods Procedural data of all DCB deployed between March 2022 to May 2024 at Calderdale Royal Hospital, was collected from patient's hospital electronic health records. Baseline co-morbidities, indication for angiogram, DCB size and length, use of intra-coronary assessment and cardiovascular outcomes till date, were recorded. All procedures deployed SeQuent Please Neo DCBs. Results A total of 221 patients underwent (Male 78.7%) coronary angioplasty involving DCB. Ninety-one (41.2%) patients underwent sole DCB angioplasty, in comparison to 130 (58.8%) patients undergoing DCB in conjunction with Drug Eluting Stent (DES). Non-ST Segment Elevation Myocardial Infarction (NSTEMI) (n=103, 46.6%) was the commonest indication for patients undergoing invasive angiogram. Forty-six (20.8%) of total cohort had DCB's deployed for in-stent restenosis (ISR) whereas majority underwent DCB strategy for angiographic small vessel disease ( n=93, 42.2%) as well as prognostic bifurcation of main vessels and their associated side branches (n=49, 22.2%). Six and 12-month follow up of cardiovascular outcomes highlighted encouraging results with respect to patients undergoing further revascularisation post DCB (n=4, 1.8%), cardiovascular hospitalisation (n=20, 9%) and cardiovascular mortality (n=0). Conclusion In this single centre retrospective analysis, use of DCB in treatment of ISR, small vessel disease and prognostic bifurcation lesions concludes encouraging results with respect to cardiovascular endpoints. Whether DCB can replace DES in proximal lesion as denovo strategy, is still to be further explored. References Belkacemi A, Agostoni P, Voskuil M, et al. Drug-eluting balloons in coronary artery disease-current and future perspectives. ICR. 2011. Neumann FJ, Sousa-Uva M, Ahlsson A, et al. ESC Scientific Document Group. 2018 ESC/EACTS guidelines on myocardial revascularization. Eur Heart J. 2019.
Wahab et al. (Wed,) studied this question.