Basavarajaiah Sandeep, Kalkat Harkaran, Bhatia Gurbir, Cortese Bernardo
Heartlands Hospital, University Hospital Birmingham, Birmingham, UK.
Clinica Polispecialistica San Carlo, Paderno Dugnano-Milano, Italy.
Catheter Cardiovasc Interv. 2023 Dec;102(7):1238-1257. doi: 10.1002/ccd.30851. Epub 2023 Nov 10.
Drug-coated balloons (DCB) offer an excellent alternative to stents as the antiproliferative drugs are delivered via balloons and hence there is no permanent implant of metal or polymer. This rationale applies perfectly in in-stent restenosis (ISR) as we want to avoid another layer of metal in a previously failed stent. However, their use has also been extended to de novo lesions especially in patients and lesion subsets where stents are not ideal. There is an increased desire toward expanding this further and studies are now being done which are testing DCB in large-caliber vessels. As the use of DCB is escalating, we felt the importance of writing this article whereby we aim to provide important tips and tricks when using DCB especially for the operators who are in the early phase or have the desire of embarking this technology. From our experience, the DCB-angioplasty substantially differs on several aspects from DES-angioplasty. We have provided several case bases examples including algorithm when using DCB in ISR and de novo lesions.
药物涂层球囊（DCB）为支架提供了一种极佳的替代方案，因为抗增殖药物通过球囊输送，因此不存在金属或聚合物的永久性植入物。这一原理在支架内再狭窄（ISR）中完美适用，因为我们希望避免在先前失败的支架中再增加一层金属。然而，它们的应用也已扩展到初发病变，特别是在支架不理想的患者和病变亚组中。人们越来越希望进一步扩大其应用范围，目前正在进行一些研究，测试DCB在大口径血管中的应用。随着DCB的使用不断增加，我们觉得撰写本文很重要，旨在提供使用DCB时的重要提示和技巧，特别是对于处于早期阶段或希望采用这项技术的操作人员。根据我们的经验，DCB血管成形术在几个方面与药物洗脱支架（DES）血管成形术有很大不同。我们提供了几个病例基础示例，包括在ISR和初发病变中使用DCB的算法。
