Drug-coated Balloons To Replace Stents In Selected Coronary Artery Diseases? 

Drug-coated balloons (DCB), when used in settings where stents may not be needed, will simplify the procedure, do away with the need for a foreign body in the artery and make medications post-procedure more simple, according to Antonio Colombo, Director of Cardiac Cath Lab and Interventional Cardiology, EMO Centro Cuore Columbus, Italy.

“DCB is not an innovation replacing stents. It can be used in some settings when stents may not be needed. We need studies, follow-ups and summaries in a couple of years,” Professor Colombo said at Saifee Hospital.

Dr Nimit Shah, Consultant Interventional Cardiologist along with Professor Colombo performed a complex coronary angioplasty procedure today using DCB on a 56year-old patient with a blocked stent implanted 6 months ago.Tracing the evolution of angioplasty procedures, he said stents prevent re-narrowing of the arteries and restenosis.

Then came drug-eluting stents that have special medication on the tip of the metal to prevent re-narrowing by decreasing hyperplasia and scar formation around the stent. It brought re-narrowing after stenting that was 30% down to 10% or even less,” he said. But 10% is not zero, he observed. “When we implant a stent in a person with diabetes, the 10% becomes 20%. We solved the problem but not completely. In the last two to three years came a balloon that is able to deliver the same drug as the stent without the need for a stent. If the result of balloon dilatation is good, there is a possibility to deliver a healing drug without putting a foreign body in,” he explained.

Dr Nimit Shah further explained that in India we have high burden of diabetes, and more chances of stents getting blocked. Drug coated balloon are ideal in these patients where artery diameter is small and long length of blockages, or previously blockestents It is better to open up the blocked stent with theses balloons rather than inserting another stent.

"The revolutionary technique involving drug and carrier complex is designed to reach the inner layers of the vessel walls and act as a reservoir for the long-term release of medicine that prevents re-narrowing of the coronary artery,” said Dr Manish Doshi, MD – Concept Medical & Inventor – World’s First Sirolimus Drug Coated Balloon. Dr Hardik Ajmera, Medical Director at Saifee hospital had a fruitful interaction with Professor Colombo, where they discussed about Saifee Hospital participating in multicenter international study using DCB in diabetic patients