Skip to main content
Top
Published in: Clinical Research in Cardiology 6/2013

01-06-2013 | Original Paper

Treatment of a coronary bifurcation lesion with drug-coated balloons: lumen enlargement and plaque modification after 6 months

Authors: Bruno Scheller, Dieter Fischer, Yvonne P. Clever, Franz X. Kleber, Ulrich Speck, Michael Böhm, Bodo Cremers

Published in: Clinical Research in Cardiology | Issue 6/2013

Login to get access

Abstract

We report a male with a coronary bifurcation lesion in the mid circumflex artery (CX). After predilatation, the lesion was treated with two drug-coated balloons (DCB). Primary success in the posterolateral branch was good; however the CX lesion had a residual stenosis including a non-flow-limiting type A dissection. After 6 months, angiography showed slight lumen enlargement in both branches of the bifurcation. Intravascular ultrasound identified about 35 % atherosclerotic plaque load within the inner area of the bifurcation but more than 50 % concentric atherosclerotic plaque burden in the vessel areas proximal and distal to the DCB-treated area.
Literature
1.
go back to reference Sigwart U, Puel J, Mirkovitch V, Joffre F, Kappenberger L (1987) Intravascular stents to prevent occlusion and restenosis after transluminal angioplasty. New Engl J Med 316:701–706PubMedCrossRef Sigwart U, Puel J, Mirkovitch V, Joffre F, Kappenberger L (1987) Intravascular stents to prevent occlusion and restenosis after transluminal angioplasty. New Engl J Med 316:701–706PubMedCrossRef
2.
go back to reference Morice MC, Serruys PW, Sousa JE et al (2002) A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization. New Engl J Med 346:1773–1780PubMedCrossRef Morice MC, Serruys PW, Sousa JE et al (2002) A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization. New Engl J Med 346:1773–1780PubMedCrossRef
3.
go back to reference Joner M, Finn AV, Farb A et al (2006) Pathology of drug-eluting stents in humans: delayed healing and late thrombotic risk. J Am Coll Cardiol 48:193–202PubMedCrossRef Joner M, Finn AV, Farb A et al (2006) Pathology of drug-eluting stents in humans: delayed healing and late thrombotic risk. J Am Coll Cardiol 48:193–202PubMedCrossRef
4.
go back to reference Nakazawa G, Vorpahl M, Finn AV, Narula J, Virmani R (2009) One step forward and two steps back with drug-eluting-stents: from preventing restenosis to causing late thrombosis and nouveau atherosclerosis. JACC Cardiovasc Imaging 2:625–628PubMedCrossRef Nakazawa G, Vorpahl M, Finn AV, Narula J, Virmani R (2009) One step forward and two steps back with drug-eluting-stents: from preventing restenosis to causing late thrombosis and nouveau atherosclerosis. JACC Cardiovasc Imaging 2:625–628PubMedCrossRef
5.
go back to reference Scheller B, Hehrlein C, Bocksch W et al (2006) Treatment of coronary in-stent restenosis with a paclitaxel-coated balloon catheter. New Engl J Med 355:2113–2124PubMedCrossRef Scheller B, Hehrlein C, Bocksch W et al (2006) Treatment of coronary in-stent restenosis with a paclitaxel-coated balloon catheter. New Engl J Med 355:2113–2124PubMedCrossRef
6.
go back to reference Tepe G, Zeller T, Albrecht T et al (2008) Local delivery of paclitaxel to inhibit restenosis during angioplasty of the leg. New Engl J Med 358:689–699PubMedCrossRef Tepe G, Zeller T, Albrecht T et al (2008) Local delivery of paclitaxel to inhibit restenosis during angioplasty of the leg. New Engl J Med 358:689–699PubMedCrossRef
7.
go back to reference Scheller B, Clever YP, Kelsch B et al (2012) Long-term follow-up after treatment of coronary in-stent restenosis with a paclitaxel-coated balloon catheter. JACC Cardiovasc Interv 5:323–330PubMedCrossRef Scheller B, Clever YP, Kelsch B et al (2012) Long-term follow-up after treatment of coronary in-stent restenosis with a paclitaxel-coated balloon catheter. JACC Cardiovasc Interv 5:323–330PubMedCrossRef
8.
go back to reference Unverdorben M, Vallbracht C, Cremers B et al (2009) Paclitaxel-coated balloon catheter versus paclitaxel-coated stent for the treatment of coronary in-stent restenosis. Circulation 119:2986–2994PubMedCrossRef Unverdorben M, Vallbracht C, Cremers B et al (2009) Paclitaxel-coated balloon catheter versus paclitaxel-coated stent for the treatment of coronary in-stent restenosis. Circulation 119:2986–2994PubMedCrossRef
9.
go back to reference Unverdorben M, Kleber FX, Heuer H et al (2010) Treatment of small coronary arteries with a paclitaxel-coated balloon catheter. Clin Res Cardiol 99:165–174PubMedCrossRef Unverdorben M, Kleber FX, Heuer H et al (2010) Treatment of small coronary arteries with a paclitaxel-coated balloon catheter. Clin Res Cardiol 99:165–174PubMedCrossRef
10.
go back to reference Wohrle J, Birkemeyer R, Markovic S et al (2011) Prospective randomised trial evaluating a paclitaxel-coated balloon in patients treated with endothelial progenitor cell capturing stents for de novo coronary artery disease. Heart 97:1338–1342PubMedCrossRef Wohrle J, Birkemeyer R, Markovic S et al (2011) Prospective randomised trial evaluating a paclitaxel-coated balloon in patients treated with endothelial progenitor cell capturing stents for de novo coronary artery disease. Heart 97:1338–1342PubMedCrossRef
11.
go back to reference Rosli R, Zambahari R et al (2011) Paclitaxel-eluting balloon angioplasty and cobalt-chromium stents versus conventional angioplasty and paclitaxel-eluting stents in the treatment of native coronary artery stenoses in patients with diabetes mellitus. EuroInterv J EuroPCR Collab Work Group Interv Cardiol Eur Soc Cardiol 7:K83–K91 Rosli R, Zambahari R et al (2011) Paclitaxel-eluting balloon angioplasty and cobalt-chromium stents versus conventional angioplasty and paclitaxel-eluting stents in the treatment of native coronary artery stenoses in patients with diabetes mellitus. EuroInterv J EuroPCR Collab Work Group Interv Cardiol Eur Soc Cardiol 7:K83–K91
12.
go back to reference Habara S, Mitsudo K, Kadota K et al (2011) Effectiveness of paclitaxel-eluting balloon catheter in patients with sirolimus-eluting stent restenosis. JACC Cardiovasc Interv 4:149–154PubMedCrossRef Habara S, Mitsudo K, Kadota K et al (2011) Effectiveness of paclitaxel-eluting balloon catheter in patients with sirolimus-eluting stent restenosis. JACC Cardiovasc Interv 4:149–154PubMedCrossRef
13.
go back to reference Rittger H, Brachmann J, Sinha AM, et al (2012) A randomized, multicenter, single-blinded trial comparing paclitaxel-coated balloon angioplasty with plain balloon angioplasty in drug-eluting stent restenosis: the PEPCAD-DES study. J Am Coll Cardiol 59(15):1377–1382 Rittger H, Brachmann J, Sinha AM, et al (2012) A randomized, multicenter, single-blinded trial comparing paclitaxel-coated balloon angioplasty with plain balloon angioplasty in drug-eluting stent restenosis: the PEPCAD-DES study. J Am Coll Cardiol 59(15):1377–1382
14.
go back to reference Wohrle J, Zadura M, Mobius-Winkler S et al (2012) SeQuent Please World Wide Registry: clinical results of SeQuent please paclitaxel-coated balloon angioplasty in a large-scale, prospective registry study. J Am Coll Cardiol 60:1733–1738PubMedCrossRef Wohrle J, Zadura M, Mobius-Winkler S et al (2012) SeQuent Please World Wide Registry: clinical results of SeQuent please paclitaxel-coated balloon angioplasty in a large-scale, prospective registry study. J Am Coll Cardiol 60:1733–1738PubMedCrossRef
15.
go back to reference Kleber FX, Mathey DG, Rittger H, Scheller B (2011) How to use the drug-eluting balloon: recommendations by the German consensus group. EuroIntervention 7(Suppl K):K125–K128PubMedCrossRef Kleber FX, Mathey DG, Rittger H, Scheller B (2011) How to use the drug-eluting balloon: recommendations by the German consensus group. EuroIntervention 7(Suppl K):K125–K128PubMedCrossRef
16.
go back to reference Werk M, Albrecht T, Meyer DR et al (2012) Paclitaxel-coated balloons reduce restenosis after femoro-popliteal angioplasty: evidence from the randomized PACIFIER trial. Circ Cardiovasc Interv 5:831–840PubMedCrossRef Werk M, Albrecht T, Meyer DR et al (2012) Paclitaxel-coated balloons reduce restenosis after femoro-popliteal angioplasty: evidence from the randomized PACIFIER trial. Circ Cardiovasc Interv 5:831–840PubMedCrossRef
18.
go back to reference Serruys PW, Onuma Y, Dudek D et al (2011) Evaluation of the second generation of a bioresorbable everolimus-eluting vascular scaffold for the treatment of de novo coronary artery stenosis: 12-month clinical and imaging outcomes. J Am Coll Cardiol 58:1578–1588PubMedCrossRef Serruys PW, Onuma Y, Dudek D et al (2011) Evaluation of the second generation of a bioresorbable everolimus-eluting vascular scaffold for the treatment of de novo coronary artery stenosis: 12-month clinical and imaging outcomes. J Am Coll Cardiol 58:1578–1588PubMedCrossRef
19.
go back to reference Diletti R, Farooq V, Girasis C et al (2013) Clinical and intravascular imaging outcomes at 1 and 2 years after implantation of absorb everolimus eluting bioresorbable vascular scaffolds in small vessels. Late lumen enlargement: does bioresorption matter with small vessel size? Insight from the ABSORB cohort B trial. Heart 99:98–105PubMedCrossRef Diletti R, Farooq V, Girasis C et al (2013) Clinical and intravascular imaging outcomes at 1 and 2 years after implantation of absorb everolimus eluting bioresorbable vascular scaffolds in small vessels. Late lumen enlargement: does bioresorption matter with small vessel size? Insight from the ABSORB cohort B trial. Heart 99:98–105PubMedCrossRef
Metadata
Title
Treatment of a coronary bifurcation lesion with drug-coated balloons: lumen enlargement and plaque modification after 6 months
Authors
Bruno Scheller
Dieter Fischer
Yvonne P. Clever
Franz X. Kleber
Ulrich Speck
Michael Böhm
Bodo Cremers
Publication date
01-06-2013
Publisher
Springer-Verlag
Published in
Clinical Research in Cardiology / Issue 6/2013
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI
https://doi.org/10.1007/s00392-013-0556-3

Other articles of this Issue 6/2013

Clinical Research in Cardiology 6/2013 Go to the issue