Tag Archives: abrupt vessel closure

Disease made worse? Dr Pitt O Lim When Grüntzig extended balloon angioplasty from the leg to the heart as a minimally invasive procedure for coronary atherosclerosis in 1977, there was a 10% rate of abrupt vessel closure (AVC), possibly causing a myocardial infarction (MI).1,2 At the time, cardiac surgeons stood by, rescuing these patients with emergency coronary artery bypass grafting (CABG). Bare-metal stent (BMS), a balloon-expandable metallic-mesh scaffold was introduced 10 years later to overcome this immediate complication. The drug-eluting stent (DES), marketed from 2003, overcomes BMS’s in-stent restenosis (ISR) due to healing tiss

Introduction Dr Pitt O Lim, Consultant Cardiologist The use of drug-coated balloon (DCB) in de novo coronary artery disease has seeped through into routine practice in recent years.1 Largely unnoticed by the mainstream community, ignored by multi-national device companies and rarely discussed at international meetings. Its development actually parallels that of first-generation drug-eluting stent (DES) from the early 2000s; pioneered, propagated and instructed by expert German operators.2,3 Its efficacy is proven for in-stent re-stenosis (ISR),4 small vessel disease,5,6 high-risk bleeder,7 and where stenting might be avoided, such as in Takay