Are drug-eluting balloons (DEBs) the best way to treat in-stent restenosis? In this episode of BackTable Cardiology, host and interventional cardiologist Dr. Sameh Sayfo takes a closer look at the evolving applications of coronary DEBs with two esteemed guests from the UK, Dr. Mohammad Alkhalil and Dr. Abhishek Kumar.

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SYNPOSIS

This conversation covers the history and application of DEBs in treating in-stent restenosis (ISR) and small vessel disease, the differences between paclitaxel and limus-based drugs, the importance of lesion preparation and imaging, and the future potential of DEBs in coronary interventions. Dr. Kumar elaborates on the LOVE DEB study, which is investigating the use of DEBs in large de novo vessels, while Dr. Alkhalil shares his experiences and insights on adapting DEB technology in various clinical scenarios, including bifurcation lesions and acute myocardial infarction. The episode emphasizes the current role of DEB technology while cautioning against a reckless approach to its application.

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TIMESTAMPS

00:00 - Introduction
02:34 - Historical Perspective and Key Studies on DCB
06:30 - Mechanisms and Imaging in In-Stent Restenosis
11:39 - Comparing Paclitaxel and Limus DCBs
13:24 - Choosing the Right DCB: Factors and Preferences
17:23 - DCB in Complex Cases: Bifurcations and Beyond
24:01 - Challenges and Adoption of DCB in Europe
27:38 - The Role of Imaging in DCB Procedures
30:13 - Insights from the LOVE DEB Study
38:59 - Future Directions in DCB Technology

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RESOURCES

Dr. Sameh Sayfo Provider Profile
https://www.bswhealth.com/physician/sameh-sayfo

LOVE DEB Clinical Trial
https://clinicaltrials.gov/study/NCT05915468

The European Bifurcation Club Left Main Coronary Stent Study: A Randomized Comparison of Stepwise Provisional vs. Systematic Dual Stenting Strategies (EBC MAIN)
https://pubmed.ncbi.nlm.nih.gov/34002215/