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Duration of Dual Antiplatelet Therapy After Implantation of Drug-Coated Balloon

The drug-coated balloon (DCB) is an emerging percutaneous coronary intervention (PCI) device with theoretical advantages and promising results. Recent clinical observations have demonstrated that DCB tends to have both good efficacy and a good safety profile in the treatment of in-stent restenosis (...

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Autores principales: Zhang, Yuxuan, Zhang, Xinyi, Dong, Qichao, Chen, Delong, Xu, Yi, Jiang, Jun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8671702/
https://www.ncbi.nlm.nih.gov/pubmed/34926613
http://dx.doi.org/10.3389/fcvm.2021.762391
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author Zhang, Yuxuan
Zhang, Xinyi
Dong, Qichao
Chen, Delong
Xu, Yi
Jiang, Jun
author_facet Zhang, Yuxuan
Zhang, Xinyi
Dong, Qichao
Chen, Delong
Xu, Yi
Jiang, Jun
author_sort Zhang, Yuxuan
collection PubMed
description The drug-coated balloon (DCB) is an emerging percutaneous coronary intervention (PCI) device with theoretical advantages and promising results. Recent clinical observations have demonstrated that DCB tends to have both good efficacy and a good safety profile in the treatment of in-stent restenosis (ISR) for both bare-metal and drug-eluting stents (DES), de novo coronary artery disease (CAD), and other situation, such as high bleeding risk, chronic total occlusion, and acute coronary syndrome (ACS). Dual antiplatelet therapy (DAPT) has become an essential medication in daily clinical practice, but the optimal duration of DAPT after the implantation of a DCB remains unknown. At the time of the first in vivo implantation of paclitaxel-DCB for the treatment of ISR in 2006, the protocol-defined DAPT duration was only 1 month. Subsequently, DAPT duration ranging from 1 to 12 months has been recommended by various trials. However, there have been no randomized controlled trials (RCTs) on the optimal duration of DAPT after DCB angioplasty. Current clinical guidelines normally recommend the duration of DAPT after DCB-only angioplasty based on data from RCTs on the optimal duration of DAPT after stenting. In this review, we summarized current clinical trials on DCB-only angioplasty for different types of CADs and their stipulated durations of DAPT, and compared their clinical results such as restenosis, target lesion revascularization (TLR) and stent thrombosis event. We hope this review can assist clinicians in making reasonable decisions about the duration of DAPT after DCB implantation.
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spelling pubmed-86717022021-12-16 Duration of Dual Antiplatelet Therapy After Implantation of Drug-Coated Balloon Zhang, Yuxuan Zhang, Xinyi Dong, Qichao Chen, Delong Xu, Yi Jiang, Jun Front Cardiovasc Med Cardiovascular Medicine The drug-coated balloon (DCB) is an emerging percutaneous coronary intervention (PCI) device with theoretical advantages and promising results. Recent clinical observations have demonstrated that DCB tends to have both good efficacy and a good safety profile in the treatment of in-stent restenosis (ISR) for both bare-metal and drug-eluting stents (DES), de novo coronary artery disease (CAD), and other situation, such as high bleeding risk, chronic total occlusion, and acute coronary syndrome (ACS). Dual antiplatelet therapy (DAPT) has become an essential medication in daily clinical practice, but the optimal duration of DAPT after the implantation of a DCB remains unknown. At the time of the first in vivo implantation of paclitaxel-DCB for the treatment of ISR in 2006, the protocol-defined DAPT duration was only 1 month. Subsequently, DAPT duration ranging from 1 to 12 months has been recommended by various trials. However, there have been no randomized controlled trials (RCTs) on the optimal duration of DAPT after DCB angioplasty. Current clinical guidelines normally recommend the duration of DAPT after DCB-only angioplasty based on data from RCTs on the optimal duration of DAPT after stenting. In this review, we summarized current clinical trials on DCB-only angioplasty for different types of CADs and their stipulated durations of DAPT, and compared their clinical results such as restenosis, target lesion revascularization (TLR) and stent thrombosis event. We hope this review can assist clinicians in making reasonable decisions about the duration of DAPT after DCB implantation. Frontiers Media S.A. 2021-12-01 /pmc/articles/PMC8671702/ /pubmed/34926613 http://dx.doi.org/10.3389/fcvm.2021.762391 Text en Copyright © 2021 Zhang, Zhang, Dong, Chen, Xu and Jiang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Zhang, Yuxuan
Zhang, Xinyi
Dong, Qichao
Chen, Delong
Xu, Yi
Jiang, Jun
Duration of Dual Antiplatelet Therapy After Implantation of Drug-Coated Balloon
title Duration of Dual Antiplatelet Therapy After Implantation of Drug-Coated Balloon
title_full Duration of Dual Antiplatelet Therapy After Implantation of Drug-Coated Balloon
title_fullStr Duration of Dual Antiplatelet Therapy After Implantation of Drug-Coated Balloon
title_full_unstemmed Duration of Dual Antiplatelet Therapy After Implantation of Drug-Coated Balloon
title_short Duration of Dual Antiplatelet Therapy After Implantation of Drug-Coated Balloon
title_sort duration of dual antiplatelet therapy after implantation of drug-coated balloon
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8671702/
https://www.ncbi.nlm.nih.gov/pubmed/34926613
http://dx.doi.org/10.3389/fcvm.2021.762391
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