title: Sequential use of bare-metal stents and drug-coated balloons to treat coronary artery stenosis.
abstract: BACKGROUND
  Drug-coated balloons (DCBs) are increasingly used in percutaneous coronary intervention (PCI). The sequential use of DCB and bare-metal stent (BMS) represents a novel approach and results of pilot studies have been encouraging. The aim of this study was to assess long-term outcomes of patients who received treatment with DCB and BMS and additionally study whether the order (BMS or DCB first) affected outcomes.
  
  
  METHODS
  This is a single-center, non-randomized, prospective study of patients who underwent PCI between July 2009 and July 2011. Two groups were defined: DCB followed by BMS (DCB→BMS) or BMS followed by DCB (BMS→DCB). Our primary outcome was target lesion revascularization (TLR) at 7 months.
  
  
  RESULTS
  A total of 128 patients (173 lesions) with a mean age of 67 years were included. The BMS→DCB group consisted of 53 patients (78 lesions) and the DCB→BMS group consisted of 75 patients (95 lesions). The mean follow-up was 7.4 months. The TLR rate was 4/76 (5%) in the BMS→DCB group and 3/90 (3%) in the DCB→BMS group (P=.83).
  
  
  CONCLUSIONS
  Our study demonstrates good results of sequential BMS and DCB use in an all-comers population. If confirmed by larger studies, this could be a valuable approach in patients with contraindications to drug-eluting stent implantation.
authors.affiliation: Department of Cardiology, Luzerner Kantonsspital, Lucerne, Switzerland.
authors.forename: Remo
authors.initials: R
authors.lastname: Beeler
authors.forename: Florim
authors.initials: F
authors.lastname: Cuculi
authors.forename: Mabelle
authors.initials: M
authors.lastname: Young
authors.forename: Paul
authors.initials: P
authors.lastname: Erne
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation* / Q000379:methods; D023921:Coronary Stenosis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation / Q000379:methods; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
chemical_list: D017239:Paclitaxel