Published online Jun 26, 2015. doi: 10.4330/wjc.v7.i6.311
Peer-review started: January 8, 2015
First decision: January 20, 2015
Revised: March 11, 2015
Accepted: April 16, 2015
Article in press: April 20, 2015
Published online: June 26, 2015
Processing time: 168 Days and 16.7 Hours
We evaluated the clinical feasibility of using drug-coated balloon (DCB) angioplasty in patients undergoing primary percutaneous coronary intervention (PPCI). Between January 2010 to September 2014, 89 ST-elevation myocardial infarction patients (83% male, mean age 59 ± 14 years) with a total of 89 coronary lesions were treated with DCB during PPCI. Clinical outcomes are reported at 30 d follow-up. Left anterior descending artery was the most common target vessel for PCI (37%). Twenty-eight percent of the patients had underlying diabetes mellitus. Mean left ventricular ejection fraction was 44% ± 11%. DCB-only PCI was the predominant approach (96%) with the remaining 4% of patients receiving bail-out stenting. Thrombolysis in Myocardial Infarction (TIMI) 3 flow was successfully restored in 98% of patients. An average of 1.2 ± 0.5 DCB were used per patient, with mean DCB diameter of 2.6 ± 0.5 mm and average length of 23.2 ± 10.2 mm. At 30-d follow-up, there were 4 deaths (4.5%). No patients experienced abrupt closure of the infarct-related artery and there was no reported target-lesion failure. Our preliminary experience showed that DCB angioplasty in PPCI was feasible and associated with a high rate of TIMI 3 flow and low 30-d ischaemic event.
Core tip: Primary percutaneous coronary intervention (PPCI) is the preferred reperfusion therapy for ST-elevation myocardial infarction (STEMI). Stent implantation is considered as a routine during PPCI as it is associated with reduction of ischaemic end-points. Drug-coated balloon (DCB) has emerged as a new therapeutic option to treat coronary artery disease as stent technology has certain limitations. There is however limited data on the feasibility of using DCB as primary therapy in PPCI. We evaluated the clinical safety and efficacy of using paclitaxel-coated balloon in patients undergoing PPCI for STEMI and report on our 30 d clinical outcomes.