Conference Coverage
TCT: Scoring balloon boosts efficacy against in-stent restenosis
Key clinical point: Pretreating in-stent restenosis with a scoring balloon before using a drug-coated balloon significantly boosted efficacy....
SAN FRANCISCO – Drug-coated balloons have become a widely used option in Europe for treating coronary in-stent restenosis, and the scoring-balloon pretreatment tested in ISAR-DESIRE 4 appeared to boost the efficacy of a drug-coated balloon in a clinically meaningful way, Dr. Marco Valgimigli said in an interview at the Transcatheter Cardiovascular Therapeutics annual meeting.
When patients develop restenosis within a coronary stent, many times it’s because the stent was not properly expanded during initial placement. An advantage to a drug-coated balloon is that it pairs well with therapeutic reexpansion of the existing stent to its proper, fully open position.
In addition, this approach spares the patient from receiving a second stent inside the first stent, said Dr. Valgimigli, an interventional cardiologist at Inselspital in Bern, Switzerland.
Often when patients develop in-stent restenosis, it tends to keep recurring. And when that happens, eventually the only remaining option for effective revascularization of the patient’s coronary arteries is coronary bypass surgery.
Pretreating in-stent restenosis with a scoring balloon prior to treatment with a drug-coated balloon improved efficacy in the ISAR-DESIRE 4 trial by a modest amount. But if this treatment strategy can successfully defer or obviate just a few cases that might otherwise require coronary bypass surgery, then using the scoring balloon is a reasonable approach, Dr. Valgimigli said at the meeting, sponsored by the Cardiovascular Research Foundation.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel.
On Twitter @mitchelzoler