Technical Mastery: Guidance on Proper Imaging, Lesion Preparation, and Deployment for Coronary Drug-Coated Balloons. Part 2: Coronary DCBs in De Novo Lesions, Small Vessel, and Bifurcation: The European Experience-Case: Long Lesion Involving Bifurcation in Patient with ACS, Dr. Tanveer Rab

Case: Long Lesion Involving Bifurcation in Patient with ACS, Dr. Tanveer Rab

Video Transcription

Video Summary

The video presents a detailed discussion of a complex case involving a 60-year-old male with metastatic male breast cancer and acute coronary syndrome, exhibiting multi-vessel small-caliber coronary disease with bifurcation lesions. The patient, not a candidate for CABG, was treated with drug-coated balloons (DCB) and drug-eluting stents for de novo small vessel lesions, focusing on the circumflex artery. The procedure included imaging guidance, balloon pre-dilation, cutting balloon modification for calcified ostial lesions, and prolonged DCB inflation to optimize drug delivery and reduce recoil or dissection progression. The presenters emphasize the importance of imaging in de novo lesions, careful lesion preparation, and tailored balloon techniques. They also discuss procedural considerations like balloon inflation duration, patient monitoring post-DCB, and anticoagulation management. Emerging evidence supports specialized balloons for lesion preparation. Overall, the case underscores that for complex bifurcation lesions in ACS with contraindications for surgery, DCB combined with meticulous technique and imaging is a viable strategy.

Keywords

metastatic male breast cancer

acute coronary syndrome

drug-coated balloons

bifurcation lesions

small vessel coronary disease