Lots of interesting abstracts and cases were submitted for TCTAP 2024. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!
TCTAP A-032
Safety and Feasibility of Sirolimus- Drug Coated Balloon in ST- Segment Elevation Myocardial Infarction
By Damon Jie Hui Tan, An Shing Ang, Cliff Li, Hee Hwa Ho
Presenter
Damon Jie Hui Tan
Authors
Damon Jie Hui Tan1, An Shing Ang1, Cliff Li1, Hee Hwa Ho1
Affiliation
Tan Tock Seng Hospital, Singapore1
View Study Report
TCTAP A-032
DES/BRS/DCB
Safety and Feasibility of Sirolimus- Drug Coated Balloon in ST- Segment Elevation Myocardial Infarction
Damon Jie Hui Tan1, An Shing Ang1, Cliff Li1, Hee Hwa Ho1
Tan Tock Seng Hospital, Singapore1
Background
Drug Coated Balloon (DCB) angioplasty is an attractive method of coronary revascularisation without leaving any metal behind. Prior studies have shown the feasibility of paclitaxel coated DCBs in ST-Segment Elevation Myocardial Infarction (STEMI), but little is known about the feasibility of sirolimus coated DCB in STEMI.
We evaluated the safety and feasibility including 9-month clinical outcomes of utilizing Selution Sustained Limus Release (SLR)™ sirolimus-coated balloon (M.A. MedAlliance SA, Nyon, Switzerland) in a cohort of patients undergoing primary percutaneous coronary intervention (PCI) for STEMI.
We evaluated the safety and feasibility including 9-month clinical outcomes of utilizing Selution Sustained Limus Release (SLR)™ sirolimus-coated balloon (M.A. MedAlliance SA, Nyon, Switzerland) in a cohort of patients undergoing primary percutaneous coronary intervention (PCI) for STEMI.
Methods
A retrospective analysis of 34 patients who presented with STEMI and underwent primary PCI with sirolimus coated DCB in a Singapore center between July 2021 to January 2023 was conducted. Clinical data was extracted from electronic medical records with follow up on 9-month clinical outcomes.
Results
Median age of the 34 patients was 56.7 years. Left Anterior Descending, Left Circumflex and Right coronary artery were culprit lesion in 9 (26%), 15 (44%) and 10 (29%) patients respectively. Mean left ventricular ejection fraction was 43%. 9 (26%) patients presented with cardiogenic shock.
24 (71%) patients had 1 DCB, 9 (26%) had 2 DCB and 1 (3%) patient had 3 DCB used. Mean post DCB residual stenosis was 32%. Mean diameter and length of DCB was 2.48 ± 0.48 mm and 21.9 ± 6.4 mm respectively. No bail-out stenting was required and there was no acute closure of vessel post PCI. All patients had TIMI 3 flow at the end of procedure.
At 9 months follow up, 3 (9%) patients died. 2 demised in the same admission (both from cardiogenic shock, with one having concurrent ventilator associated pneumonia) with no recurrent ST elevation on repeat electrocardiogram to suggest recurrent Myocardial Infarction. 1 demised from cellulitis 9 months after PCI. 2 patients (5.9%) experienced angina (1 was for medical therapy, not requiring investigation with resolving symptoms). Major adverse cardiac event rate was 8.8% (3 patients).
24 (71%) patients had 1 DCB, 9 (26%) had 2 DCB and 1 (3%) patient had 3 DCB used. Mean post DCB residual stenosis was 32%. Mean diameter and length of DCB was 2.48 ± 0.48 mm and 21.9 ± 6.4 mm respectively. No bail-out stenting was required and there was no acute closure of vessel post PCI. All patients had TIMI 3 flow at the end of procedure.
At 9 months follow up, 3 (9%) patients died. 2 demised in the same admission (both from cardiogenic shock, with one having concurrent ventilator associated pneumonia) with no recurrent ST elevation on repeat electrocardiogram to suggest recurrent Myocardial Infarction. 1 demised from cellulitis 9 months after PCI. 2 patients (5.9%) experienced angina (1 was for medical therapy, not requiring investigation with resolving symptoms). Major adverse cardiac event rate was 8.8% (3 patients).
Conclusion
The 9 months experience showed that the use of sirolimus eluting DCB in primary PCI for STEMI is safe and feasible, with good intermediate term clinical outcomes and low incidence of adverse events. More data is required to look at longer term outcomes.