Sirolimus-Coated Balloon With a Microsphere-Based Technology for the Treatment of De Novo or Restenotic Coronary Lesions

• Published in: Cardiovascular revascularization medicine 2022-12, Vol.45, p.18-25
• Main Authors: Costa, Ricardo A., Mandal, Sankar C., Hazra, Prakash K., Chopda, Manoj, Chandra, Praveen, Damiani, Lucas P., Abizaid, Alexandre, Hiremath, Shirish
• Format: Article
• Language: English
• Subjects: Balloon angioplasty; Constriction, Pathologic; Coronary artery disease; Drug-coated balloon; Drug-Eluting Stents; Humans; Prospective Studies; Quantitative coronary angiography; Sirolimus; Sirolimus - adverse effects; Technology
• ISSN: 1553-8389; 1878-0938
• DOI: 10.1016/j.carrev.2022.08.037

Non stent-based local drug delivery with drug-coated balloon (DCB) is an alternative to drug-eluting stent with favorable clinical applicability in the treatment of selected coronary lesions. Our purpose was to report the initial performance, safety and efficacy evaluations of a novel sirolimus-coated balloon in the treatment of coronary lesions. This was a phase I (first-in-man), prospective, multicenter, single-arm trial evaluating the novel SELUTION SLR™ DCB (M.A. Med Alliance SA, Nyon, Switzerland), which incorporates a polymeric microsphere-based technology for controlled and continuous release of sirolimus, in the treatment of de novo or restenotic lesions. A total of 56 patients/lesions were enrolled between November/2018 and March/2019. Diabetes was found in 46.6 %, and de novo lesions represented 79.6 % of cases. Device and procedural/clinical success were 100 % and 96.4 %, respectively. There was only one major adverse cardiac event (target lesion revascularization) reported at late follow-up. By quantitative coronary angiography analysis, mean % diameter stenosis was 30.5 ± 16.7 %, late lumen loss was 0.26 ± 0.45 mm and angiographic binary restenosis occurred in 4 of 45 cases at 6-month angiographic follow-up. The novel SELUTION sirolimus-coated balloon demonstrated safety and efficacy in the treatment of diseased coronary vessels, including absence of mortality and relatively low late lumen loss at late follow-up. •DCB may be preferable when PCI with a stent is not desirable, such as for in-stent restenosis, side branch and small vessels•Sirolimus DCB may be a safe and effective alternative for the treatment of de novo and restenotic coronary lesions•New drug-release technology for DCB with microsphere-based drug release offers a more robust and controlled drug delivery