Reviews in Cardiovascular Medicine (Jan 2022)

Drug-coated balloon for the management of coronary chronic total occlusions

  • Erick Sanchez-Jimenez,
  • Rami El-Mokdad,
  • Rima Chaddad,
  • Bernardo Cortese

DOI
https://doi.org/10.31083/j.rcm2302042
Journal volume & issue
Vol. 23, no. 2
p. 042

Abstract

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There is a higher rate of successful recanalization of patients with coronary chronic total occlusions, nevertheless, the rate of patients referred for revascularization remains low. In addition, there is a greater need to improve long-term outcomes of chronic total occlusions after percutaneous coronary intervention, and although the implantation of new-generation drug-eluting stents has been optimized with coronary imaging guidance, the rate of stenting failure remains a major issue and long-term vessel patency could be improved. We reviewed clinical data regarding the benefit of treating chronic total occlusions and the use of drug-coated balloons as an alternative therapeutic modality in this setting. Although clinical data is limited, the initial evidence and the daily clinical practice point towards a synergistic hybrid treatment strategy based on the combination of drug-coated balloons plus drug-eluting stents, reducing the total stent length and maintaining the scaffolding properties of stents where it is mandatory. Additionally, drug-coated balloons allow natural enlargement of the open vessel after percutaneous coronary intervention (PCI), which is a major limitation of stents in chronic total occlusion (CTO).

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