Skip to main content

Dissection Management with Drug-Coated Balloons

  • Chapter
  • First Online:
Drug-Coated Balloons

Abstract

In the “pre-stent era,” the immediate and midterm outcome of percutaneous transluminal coronary angioplasty (PTCA) was severely affected by restenosis, abrupt vessel closure, and coronary dissection. Regardless of the angiographic and morphological classification {Waller:1992tr}, the incidence of coronary dissection after PTCA has been reported ranging from 4% to 45% {Dorros:1983wf}{GuiterasVal:1987wy}, while autoptic studies showed the presence of coronary dissections in up to 80% of the cases, independently from the cause of death {Baughman:1981gb}, of patients treated with balloon angioplasty.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Waller BF, Orr CM, Pinkerton CA, Van Tassel J, Peters T, Slack JD. Coronary balloon angioplasty dissections: “the good, the bad and the ugly”. J Am Coll Cardiol. 1992;20:701–6.

    Article  CAS  Google Scholar 

  2. Dorros G, Cowley MJ, Simpson J, Bentivoglio LG, Block PC, Bourassa M, Detre K, Gosselin AJ, Grüntzig AR, Kelsey SF, Kent KM, Mock MB, Mullin SM, Myler RK, Passamani ER, Stertzer SH, Williams DO. Percutaneous transluminal coronary angioplasty: report of complications from the National Heart, Lung, and Blood Institute PTCA Registry. Circulation. 1983;67:723–30.

    Article  CAS  Google Scholar 

  3. Guiteras Val P, Bourassa MG, David PR, Bonan R, Crépeau J, Dyrda I, Lespérance J. Restenosis after successful percutaneous transluminal coronary angioplasty: the Montreal Heart Institute experience. Am J Cardiol. 1987;60:50B–5B.

    CAS  PubMed  Google Scholar 

  4. Baughman KL, Pasternak RC, Fallon JT, Block PC. Transluminal coronary angioplasty of postmortem human hearts. Am J Cardiol. 1981;48:1044–7.

    Article  CAS  Google Scholar 

  5. Cappelletti A, Margonato A, Rosano G, Mailhac A, Veglia F, Colombo A, Chierchia SL. Short- and long-term evolution of unstented nonocclusive coronary dissection after coronary angioplasty. J Am Coll Cardiol. 1999;34:1484–8.

    Article  CAS  Google Scholar 

  6. Albertal M, Van Langenhove G, Regar E, Kay IP, Foley D, Sianos G, Kozuma K, Beijsterveldt T, Carlier SG, Belardi JA, Boersma E, Sousa JE, de Bruyne B, Serruys PW, DEBATE II Study Group. Uncomplicated moderate coronary artery dissections after balloon angioplasty: good outcome without stenting. Heart. 2001;86:193–8.

    Article  CAS  Google Scholar 

  7. Amin N, De Vito Dabbs A, Gilchrist IC. Serial angiographic appearance of healing dissection after balloon angioplasty. Cathet Cardiovasc Diagn. 1994;33:237–40.

    Article  CAS  Google Scholar 

  8. Tepe G, Zeller T, Schnorr B, Claussen CD, Beschorner U, Brechtel K, Scheller B, Speck U. High-grade, non-flow-limiting dissections do not negatively impact long-term outcome after paclitaxel-coated balloon angioplasty: an additional analysis from the THUNDER study. J Endovasc Ther. 2013;20:792–800.

    Article  Google Scholar 

  9. Agostoni P, Belkacemi A, Voskuil M, Nathoe HM, Doevendans PA, Stella PR. Serial morphological and functional assessment of drug-eluting balloon for in-stent restenotic lesions: mechanisms of action evaluated with angiography, optical coherence tomography, and fractional flow reserve. JACC Cardiovasc Interv. 2013;6:569–76.

    Article  Google Scholar 

  10. Fukushima T, Ashikaga T, Yoshikawa S, Hatano Y, Ueshima D, Yamamoto T, Yasuhiro M, Isobe M. Effect of drug-coated balloon on stent restenosis, neointimal proliferation, and coronary dissection: an optical coherence tomography analysis. Coron Artery Dis. 2017;29:39–45.

    Google Scholar 

  11. Kleber FX, Schulz A, Waliszewski M, Hauschild T, Böhm M, Dietz U, Cremers B, Scheller B, Clever YP. Local paclitaxel induces late lumen enlargement in coronary arteries after balloon angioplasty. Clin Res Cardiol. 2015;104:217–25.

    Article  CAS  Google Scholar 

  12. Speck U, Cremers B, Kelsch B, Biedermann M, Clever YP, Schaffner S, Mahnkopf D, Hanisch U, Böhm M, Scheller B. Do pharmacokinetics explain persistent restenosis inhibition by a single dose of paclitaxel? Circ Cardiovasc Interv. 2012;5:392–400.

    Article  CAS  Google Scholar 

  13. Aoki J, Colombo A, Dudek D, Banning AP, Drzewiecki J, Zmudka K, Schiele F, Russell ME, Koglin J, Serruys PW, TAXUS II Study Group. Peristent remodeling and neointimal suppression 2 years after polymer-based, paclitaxel-eluting stent implantation: insights from serial intravascular ultrasound analysis in the TAXUS II study. Circulation. 2005;112:3876–83.

    Article  CAS  Google Scholar 

  14. Her AY, Ann SH, Singh GB, Kim YH, Okamura T, Garg S, Koo BK, Shin ES. Serial morphological changes of side-branch ostium after paclitaxel-coated balloon treatment of de novo coronary lesions of main vessels. Yonsei Med J. 2016;57:606–13.

    Article  CAS  Google Scholar 

  15. Nakazawa G, Finn AV, Vorpahl M, Ladich ER, Kolodgie FD, Virmani R. Coronary responses and differential mechanisms of late stent thrombosis attributed to first-generation sirolimus- and paclitaxel-eluting stents. J Am Coll Cardiol. 2011;57:390–8.

    Article  CAS  Google Scholar 

  16. Clever YP, Peters D, Calisse J, Bettink S, Berg M-C, Sperling C, Stoever M, Cremers B, Kelsch B, Böhm M, Speck U, Scheller B. Novel sirolimus-coated balloon catheter: in vivo evaluation in a porcine coronary model. Circ Cardiovasc Interv. 2016;e003543:9.

    Google Scholar 

  17. Piraino D, Buccheri D, Cortese B. Paclitaxel-coated balloon exerts late vessel healing and enlargement: a documented phenomenon with optical coherence tomography analysis. Int J Cardiol. 2016;203:551–2.

    Article  Google Scholar 

  18. Piraino D, Cortese B, Buccheri D, Dendramis G, Andolina G. Healing after coronary artery dissection: the effect of a drug coated balloon angioplasty in a bifurcation lesion. A lesson from intravascular ultrasound analysis. Int J Cardiol. 2016;203:298–300.

    Article  Google Scholar 

  19. Cortese B, Silva Orrego P, Agostoni P, Buccheri D, Piraino D, Andolina G, Seregni RG. Effect of drug-coated balloons in native coronary artery disease left with a dissection. JACC Cardiovasc Interv. 2015;8:2003–9.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Di Palma, G., Cortese, B. (2019). Dissection Management with Drug-Coated Balloons. In: Cortese, B. (eds) Drug-Coated Balloons . Springer, Cham. https://doi.org/10.1007/978-3-319-92600-1_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-92600-1_12

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-92599-8

  • Online ISBN: 978-3-319-92600-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics