Key result
PBA shows comparable 2-year patency to DES in small coronary vessels in a case report.
Why the study?
While PCI with drug-eluting stents has revolutionized CAD management, its role in small vessel disease remains debated due to risks like stent thrombosis and restenosis.
Does Plain Balloon Angioplasty (PBA) provide comparable outcomes to DES in small vessel coronary artery disease?
Case Report (n=1)
No
Does Plain Balloon Angioplasty (PBA) provide comparable outcomes to DES in small vessel coronary artery disease?
Plain balloon angioplasty may still have a role and provide stent-like effects in small-sized coronary vessels (<3 mm) with good long-term patency.
Should not yet change small vessel CAD practice; leaves open PBA role pending randomized trials.
Coronary Artery Disease (CAD) remains a significant public health issue, with Small Vessel Disease (SVD) representing a challenging subtype. While Percutaneous Coronary Intervention (PCI) with Drug-Eluting Stents (DES) has revolutionized the management of CAD, its role in SVD remains debated, particularly in the context of potential complications like stent thrombosis and restenosis. This case report presents a compelling example where Plain Balloon Angioplasty (PBA) successfully treated a patient with SVD, highlighting its continued relevance in specific clinical scenarios. Patient concerns: A female patient 60 years old, suffered from Insulin-dependent Diabetes Mellitus (DM), Hypertension (HTN), and dyslipidemia and had typical chest pain for the last three months on minimal exertion. The Electrocardiogram (ECG) and Echo revealed ischemic changes and regional wall motion abnormality. Diagnoses: The coronary angiography results revealed multivessel coronary artery disease. Interventions: PCI was done using balloon angioplasty to small-sized vessels (<3 mm in diameter) and DES to Left Anterior Descending Artery (LAD) and Right Coronary Artery (RCA). Then, follow-up angiography was done that showed patent stents and excellent results for balloon angioplasty-treated small vessels. Outcomes: Two years of follow-up of small coronary artery disease vessels treated with PBA were comparable to DES. Conclusion: PBA in small-sized coronary vessels showed a stent-like effect both in immediate and long-term follow-up.
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A.I. Abdelaziz (2024) conducted a case report in Small vessel coronary artery disease (n=1). Plain Balloon Angioplasty vs. Drug-Eluting Stent (DES) was evaluated on Vessel patency at 2-year follow-up. Plain balloon angioplasty in small-sized coronary vessels maintained vessel patency at two years of follow-up, showing comparable results to drug-eluting stents in the same patient.
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