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: Small Vessel, Dr. Bernardo Cortese

Video Transcription

Video Summary

The webinar focused on managing small coronary vessels using drug-coated balloons (DCBs) and drug-eluting stents (DES). Key points included deciding vessel relevance and lesion preparation before selecting treatment. DCBs are effective in small vessels but require careful lesion preparation with tools like scoring or cutting balloons. Slow, gentle balloon inflation and longer inflation times are recommended. Lesions should be reassessed after preparation; if results are suboptimal, a short stent may be used instead of a full stent to reduce risks like restenosis or thrombosis. Clinical context, such as patient bleeding risk, guides treatment choice. Experts emphasized that DCB use decision occurs after lesion prep, not beforehand. A recent meta-analysis showed DCBs reduce major adverse cardiac events compared to DES over three years. The panel highlighted the learning curve for proximal LAD cases and stressed safety, noting that bailout stenting is acceptable when needed. Overall, small vessel PCI remains common and nuanced in practice.

Keywords

drug-coated balloons

drug-eluting stents

small coronary vessels

lesion preparation

percutaneous coronary intervention