San Francisco — For the treatment of coronary artery in-stent restenosis, angioplasty with a drug-coated balloon (AGENT DCB; Boston Scientific) was superior to conventional balloon angioplasty in preventing target lesion failure at 1 year in a high-risk patient population.
Approximate 50% reductions in the rates of target lesion restenosis and target vessel myocardial infarction (MI) accounted for the superior findings with the AGENT DCB over conventional balloon angioplasty.
"For those patients treated with a balloon angioplasty, the rate of target lesion failure was 28.7%. Those treated with the AGENT paclitaxel coated balloon had a net rate of 17.9%," Robert Yeh, MD, of Beth Israel Deaconess Medical Center in Boston reported at the Transcatheter Cardiovascular Therapeutics 2023 congress on October 25, 2023. "This represented a 38% relative risk reduction as well as a 10% absolute risk reduction in the endpoint. The P value for superiority was 0.0063, highly statistically significant."
In-stent restenosis is clinically challenging and accounts for about 10% of all percutaneous coronary interventions. "Sometimes these patients have multiple layers, and that could be a third or fourth layer of stent, something that we try to avoid," he said.
Drug-coated balloons, which are not currently approved in the United States, can deliver drugs that inhibit blockages from reforming, "without leaving additional layers of metal behind," he added.
