Comparison between Drug Eluting Balloons (DEB) and Drug Eluting Stents (DES) in the treatment of de novo coronary lesions / Walid Abdelrehim Eldewy ; Supervised Soliman Gharib Ebrahim , Khaled Abd El-Azeem Shokry , Amr Hassan Mostafa

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Cardiology

The frequency of restenosis after PCI and need for repeat revascularization have been reduced with advent of drug eluting stents (DES).The major disadvantage of DES is the need for longer term dual anti platelet therapy of usually 12 months duration compared to only one month of bare metal stent (BMS), also DES come with worrying risk of stent thrombosis, due to this limitation there is a proportion of about 20 to 30 % of patient where BMS are preferred . It would be optimal if PCI could be performed without leaving behind a permanent device, one option is the use of bioabsorbable scaffolds, another alternative includes the use of drug elluting balloon (DEB). DEB has been of proven benefit for the treatment of in-stent restenosis in several small randomized trials. However, the use of DEB in the setting of de novo coronary lesions has only been addressed in few small-randomized trials with limited power for clinical endpoints. METHODS : 50 patients were randomized to either PTCA (DEB) group 1 or PCI (DES) group 2 with follow up after three months clinically and by myocardial perfusion imaging.RESULTS: Angiographic and clinical success was high (>88%) in both two groups.CONCLUSION: Current work suggests DEB efficacy and safety in coronary de novo lesions but does not support superiority or even equivalence to the best in class DES

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