Drug Coated Balloon
DCB-only All-Comers Registry

SeQuent® Please in de novo lesions, DES- and BMS-ISR

Prospective, large-scale multicenter trial for the use of drug-coated balloons in coronary lesions: The DCB-only All-Comers Registry

Rosenberg M et al. Catheter. Cardiovasc. Interv. 2019; 93(2): 181-8

Key Findings

DCB-only angioplasty with SeQuent® Please in de novo lesions is associated with low MACE and TLR rates. The authors conclude that DCBs appear to be an attractive alternative for the interventional, stent-less treatment of suitable de novo coronary lesions.

Description

Design: Open-label | Prospective | Multicenter 

Indication: De novo, ISR

Primary endpoint: TLR @ 9-month follow-up

Secondary endpoints: MACE @ 9-month follow-up. Components of MACE:

  • TLR
  • Cardiac death: Death not clearly of extracardiac origin
  • MI: Typical clinical symptoms, relevant ECG changes and/ or elevated troponin T or troponin I increases (3 × the upper limit of normal)
  • Definite vessel thrombosis: According to Academic Research Consortium definition [1]

DAPT: 

  • DCB-only: 1 month
  • DCB + stent: ≥ 6 months

Results

Patients: A total of 1,025 patients were enrolled. 686 of these patients (66.9 %) were treated in de novo lesions, 231 (22.6 %) in DES-ISR and 108 (10.5 %) in BMS-ISR.

Baseline characteristics: The different patient groups were well balanced. Statistically significant differences were observed with regards to the history of smoking and STEMI. The percentage of patients with a history of smoking was highest in the BMS-ISR group, while the percentage of STEMI was highest in the de novo group.

Primary endpoint: TLR rates at 9-month follow-up were low across all treatment groups, with a lower rate for the de novo group. 

Secondary endpoints:

 All patientsDe novoBMS-ISRDES-ISRp-value
Patients with clinical follow-up915 (89.3 %)604 (88.0 %)103 (95.4 %)208 (90.0 %)0.067
MACE6.8 %5.6 %7.8 %9.6 %0.131
TLR 3.2 % 2.3 %2.9 %5.8 %0.049
Cardiac death1.3 %1.0 %1.9 %1.9 %0.499
MI3.4 %3.6 %3.9 %2.4 %0.666
Definite vessel thrombosis0.8 %

0.5 %

1.9 %

1.0 %0.278

[1] Cutlip D et al. Circulation 2007; 115: 2344-51.