Why the study?
Stent implantation carries a 1%-2% risk of long-term complications, highlighting the need to explore DCB angioplasty as a viable alternative in very young patients with STEMI.
Does paclitaxel-coated balloon angioplasty achieve vessel patency and lumen enlargement without permanent stent implantation in a young patient with acute STEMI?
Does paclitaxel-coated balloon angioplasty achieve vessel patency and lumen enlargement without permanent stent implantation in a young patient with acute STEMI?
This case report demonstrates that paclitaxel-coated balloon angioplasty after careful lesion preparation is a feasible and safe stent-free alternative in a young STEMI patient, resulting in rapid late lumen enlargement at 7 weeks.
Answers are grounded in this paper and cite their sources.
DCB may support remodeling in young STEMI; hypothesis-generating and should not yet alter stent-first practice.
This clinical case highlights the safety and feasibility of drug coated balloon (DCB) angioplasty in a very young patients presenting with STEMI (ST-Elevation Myocardial Infarction) to avoid long-term complications associated with stent implantation, which still amount to 1%-2%. We successfully treated a 25 years old patient with occluded right coronary artery (RCA) with DCB after careful lesion preparation. Moreover, in a control angiogram 7 weeks later the RCA was patent with substantial lumen enlargement of 0.4 mm (RAO projection) to almost 2 mm (LAO projection) in a very short period of time. DCB angioplasty offers a viable alternative to stent implantation in young patients, avoiding the complications associated with permanent metallic implants while promoting vascular remodeling. While we acknowledge that more evidence is needed to optimize patient selection and confirm the long-term benefits of DCB in ACS, this case highlights its efficacy and safety in terms of an individualized treatment strategy.
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Vukadinović et al. (2025) studied this question.
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