Key result
DCB-only strategy shows promise as a safe alternative to DES in primary PCI for AMI.
Why the study?
While drug-eluting stents carry risks of in-stent restenosis and stent thrombosis in pPCI, most experience with drug-coated balloons has been gained in elective PCI, leaving experience in pPCI lacking.
Does a drug-coated balloon-only strategy improve outcomes in patients undergoing primary percutaneous coronary intervention?
Does a drug-coated balloon-only strategy improve outcomes in patients undergoing primary percutaneous coronary intervention?
This review discusses and analyzes the current evidence for the use of a drug-coated balloon-only strategy in primary percutaneous coronary intervention.
Hypothesis-generating for DCB-only PCI in AMI; randomized trials needed before clinical adoption.
According to the latest coronary interventional guidelines, a drug-eluting stent is the recommended reperfusion therapy in primary percutaneous coronary intervention (pPCI). However, deficiencies and defects, such as in-stent restenosis (ISR), incomplete stent apposition, stent thrombosis, reinfarction after stent implantation, long-term dual antiplatelet drug use, and adverse reactions of metal implants, plague clinicians and patients. Drug-coated balloon (DCB), which delivers antiproliferative agents into the vessel wall without stent implantation and leaves no implants behind after the procedure, is a novel option for percutaneous coronary intervention and has proven to be a promising strategy in cases of ISR, small vessel coronary artery disease, and bifurcation lesions. However, most of the available experience has been gained in elective percutaneous coronary intervention, and experience in pPCI is lacking. The current evidence for the use of DCB-only in pPCI was discussed and analyzed in this review.
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Zhao et al. (2023) conducted a review in Acute myocardial infarction (AMI) / ST-elevation myocardial infarction (STEMI). Drug-coated balloon (DCB) vs. Drug-eluting stent (DES) was evaluated. A review of current studies indicates that a drug-coated balloon-only strategy is a safe and promising alternative to drug-eluting stents for primary percutaneous coronary intervention in AMI.
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