Original scientific paper

https://doi.org/10.15836/ccar.2014.289

Percutaneous Coronary Interventions with Drug-eluting Balloons: Croatian Experience

Đeiti Prvulović ; General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia
Vjekoslav Tomulić ; University Hospital Centre Rijeka, Rijeka, Croatia
Maja Strozzi ; University Hospital Centre Zagreb, Zagreb, Croatia
Lovel Giunio ; University Hospital Centre Split, Split, Croatia
Jozica Šikić ; University Hospital Sveti Duh, Zagreb, Croatia
Boris Starčević ; University Hospital Dubrava, Zagreb, Croatia
Ivo Vuković ; University Hospital Centre Split, Split, Croatia

Abstract

Introduction: Drug-eluting balloons (DEB) represent a new technological platform in the area of percutaneous coronary interventions. The only accepted indication for their use is the treatment of in-stent stenosis, with no clear consensus for all other indications.
Aim: To evaluate the use of DEB in routine clinical practice in Croatia.
Methods: Retrospective nonrandomized multicentric register of all treated patients in seven Croatian centers in the time frame from February 2011 to January 2014. The data were collected from
available medical documents. There were no clinical or angiographic exclusion criteria, nor was there any written common protocol for indications or for for the clinical follow up of patients. Major adverse
cardiac events (MACE) were monitored. MACE were defined as the combination of cardiac death, development of myocardial infarction (MI) on treated vessel, and/or target lesion revascularization (TLR) for all patients during the same hospitalization, following a 6-month clinical observation and through available angiographic data.
Results: 248 patients were treated for 284 lesions. The most common indication was the in-stent restenosis present in 31.4% of the patients, for 21.4% of the patients DEB was implanted in vessels smaller than 2.75 mm, and other indications were: lesions larger than 2.8 mm, bifurcations, ostial lesion, chronic total occlusions (11.3%; 11.3%; 7.3%; 1.6% respectively). On 39 patients (15.6%) following the previous implantation of bare metal stents (BMS), postdilatation with DEB was conducted. MACE during hospitalization appeared in 1.6% of the patients: 1 death (0.4%), 3 acute thromboses (1.3%), 1 MI (0.4%).
Following the 6 month long observation, data is available for 83 patients (33%). TLR was performed on 6% of the patients, and there were no registered deaths or acute myocardial infarctions. Angiographic
follow-up was performed on 55 patients (22%) after 6 months. In 69% of the patients the findings were described as completely clean, insignificant stenosis was described for 20% of the patients, and for 11% of the patients a stenosis to the amount of >50% of full occlusion was described.
Conclusion: Our clinical experience in everyday clinical practice shows that in Croatia DEB is mostly used in cases of accepted indications of in-stent re-stenosis, but also to a great percentage for indications for which no clear consensus exists in literature. Acute angiographic results and early clinical results are excellent, and the use of DEB is highly safe.

Keywords

coronary heart disease; percutaneous coronary intervention; drug-eluting balloon

Hrčak ID:

141141

URI

https://hrcak.srce.hr/141141

Publication date:

5.9.2014.

Article data in other languages: croatian

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