title: Hybrid strategy with a bioresorbable scaffold and a drug-coated balloon for diffuse coronary artery disease: the "no more metallic cages" multicentre pilot experience.
abstract: OBJECTIVE
  Our aim was to assess the feasibility and results of a hybrid approach with a bioresorbable scaffold (BRS) plus a drug-coated balloon (DCB) for the treatment of diffuse coronary artery disease (CAD).
  
  
  RESULTS
  A retrospective analysis was performed on consecutive patients with diffuse de novo or in-stent restenosis treated with BRS implantation (larger proximal segment) and DCB inflation (smaller distal segment or bifurcation side branch). Endpoints were procedural success, then ischaemia-driven target lesion revascularisation (ID-TLR) and BRS/DCB segment thrombosis rates at follow-up. A total of 42 consecutive patients were treated with the hybrid strategy. Mean patient age was 62±1.02 years, while 12 (28.6%) patients were diabetics. Mean BRS and DCB length were 28.0±5.1 mm and 25.8±8.8 mm, respectively. Procedural success was obtained in all patients, but three (7.3%) patients required bail-out scaffolding for DCB-related dissection. At a median follow-up of 12 months (IQR: 6-18), there were no cases of cardiac death, target vessel myocardial infarction, or BRS/DCB segment thrombosis. ID-TLR occurred in two (4.7%) BRS-treated segments.
  
  
  CONCLUSIONS
  Our data in consecutive patients with diffuse CAD suggest that a hybrid strategy using BRS and DCB in different segments of the diseased vessel is feasible and associated with encouraging clinical outcomes.
authors.affiliation: Cardiology Division, Bolognini Hospital, Seriate (BG), Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Ielasi
authors.forename: Tadashi
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Salvatore
authors.initials: S
authors.lastname: Geraci
authors.forename: Luca
authors.initials: L
authors.lastname: Testa
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abdel-Wahab
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Kawamoto
authors.forename: Neil
authors.initials: N
authors.lastname: Ruparelia
authors.forename: Takao
authors.initials: T
authors.lastname: Sato
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Caramanno
authors.forename: Francesco
authors.initials: F
authors.lastname: Bedogni
authors.forename: Maurizio
authors.initials: M
authors.lastname: Tespili
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
authors.forename: Azeem
authors.initials: A
authors.lastname: Latib
mesh_terms: D020341:Absorbable Implants; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D003324:Coronary Artery Disease / Q000601:surgery*; D023903:Coronary Restenosis / Q000601:surgery*; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000601:surgery; D010865:Pilot Projects; D012189:Retrospective Studies; D016896:Treatment Outcome