Technical Mastery: Guidance on Proper Imaging, Lesion Preparation, and Deployment for Coronary Drug-Coated Balloons. Part 3: Bringing it All Together: Case Reviews of In-Stent Restenosis-Case: Double-Layer ISR, Dr. J. Dawn Abbott

Video Transcription

Video Summary

Dr. Dawn Abbott discussed the challenges of treating double-layer in-stent restenosis (ISR), particularly in complex patients with multiple prior interventions. Double-layer ISR, especially in drug-eluting stents (DES), shows higher rates of target lesion failure and restenosis compared to single-layer ISR. Abbott highlighted treatment using drug-coated balloons (DCBs) following thorough lesion preparation with non-compliant and scoring balloons, emphasizing the importance of achieving less than 30% residual stenosis before DCB application. Recent trial data (Agent trial) demonstrate that DCBs significantly reduce restenosis and target vessel myocardial infarction in double-layer ISR, offering a valuable alternative to adding further stent layers, which have poor outcomes.

Keywords

double-layer in-stent restenosis

drug-coated balloons

drug-eluting stents

lesion preparation

Agent trial