Conventional Balloon Research Articles

Novel Scaffolds for the Treatment of Below-the-Knee Peripheral Arterial Disease With Chronic Limb Threatening Ischemia: A Review

Below-the-knee (BTK) peripheral arterial disease (PAD) is a significant source of cardiovascular morbidity and mortality. Patients with chronic limb-threatening ischaemia in BTK PAD represent one of the highest-risk cohorts of PAD patients, with little progress having been made regarding long-term patency and mortality over the past four decades. Although conventional balloon angioplasty has long been the standard of care, several novel scaffolds have been introduced over the past decade with promising 1-year patency rates and freedom from clinically driven target limb revascularisation, which may herald a new age of endovascular intervention for BTK PAD. In this review, we present a critical appraisal of the literature surrounding novel scaffolds and drug-eluting technology in the treatment of BTK PAD.

One single drug-coated balloon for all shapes/diameters? Neointimal proliferation inhibition in porcine peripheral arteries.

Long diseased vessel segments of peripheral arteries may display irregular shapes with different diameters. The aim of this study was to investigate inhibition of neointimal proliferation in porcine peripheral vessels with different diameters covered by one single hyper-compliant drug-coated balloon (HCDCB), compared to conventional drug-coated balloons (DCB), each selected according to the respective vessel diameter. Neointimal proliferation was stimulated in proximal and distal segments of the peripheral arteries by balloon overstretch and stent implantation. Inhibition of neointimal proliferation by one single HCDCB was compared to two vessel diameter-adjusted DCB per artery and to one single uncoated hyper-compliant balloon (HCB). Sixteen HCB, 16 HCDCB, and 32 DCB were used in 16 arteries each. Quantitative angiography (QA), optical coherence tomography (OCT) and histology showed a similar anti-restenotic effect for one HCDCB compared to two vessel diameter-adjusted DCB in narrow distal and wider proximal segments (QA diameter stenosis: 18.7±12.3% vs. 22.8±15.5%, p = 0.535; OCT area stenosis: 21.4±11.6% vs. 23.6±12.3%, p = 0.850; histomorphometry diameter stenosis: 27.5±7.1% vs. 26.9±8.0%, p = 0.952) and indicated significant inhibition of neointimal proliferation by HCDCB vs. uncoated HCB (QA diameter stenosis: 18.7±12.3% vs. 30.3±16.7%, p = 0.008; OCT area stenosis: 21.4±11.6% vs. 34.7±16.0%, p = 0.004; histomorphometry diameter stenosis: 27.5±7.1% vs. 32.5±8.5%, p = 0.038). HCDCB were found to be similar effective as DCB in inhibiting neointimal proliferation in vessel segments with different diameters. One single long HCDCB may allow for treatment of segments with variable diameters, and thus, replace the use of several vessel diameter-adjusted DCB.

Comparison of drug-coated balloon with conventional balloon for angioplasty in symptomatic intracranial atherosclerotic stenosis

BackgroundDrug-coated balloon (DCB) angioplasty has been studied for reducing the occurrence of restenosis after treatment for intracranial atherosclerotic stenosis (ICAS), but no comparison has been published of the use of...

Provisional Stenting Techniques Using A Novel Modified Jailed Balloon

Coronary bifurcation lesions are frequently found; account for one-fifth of all Percutaneous Coronary Interventions (PCI), and are considered as complex cases to treat. The provisional stenting strategy is thought of as the stenting of choice for most coronary bifurcation lesions. Still, it has a risk of side branch (SB) occlusion after the main vessel (MV) stenting. Several strategies have been proposed to overcome this challenge. Jailed balloon technique (JBT), first proposed by Burzotta et al. in 2010 was a more recent modification of jailed wire technique (JWT) to further decrease the risk for SB occlusion during crossover stenting in bifurcation lesion. Since then, certain modifications had been tested to the conventional jailed balloon technique to maximize SB protection during the provisional stenting strategy. We tried to make a mini case series of 6 patients with application of jailed ballon technique with some modifications in bifurcation lesion with provisional stenting strategy and evaluate its efficacy and safety, with quite satisfying results. Our novel JBT technique had some different characteristics from previous JBT techniques and aimed at simplifying the procedure while preserving side branch during crossover stenting.

Drug-Coated Balloon versus Plain Balloon Angioplasty in the Treatment of Infrainguinal Vein Bypass Stenosis: A Systematic Review and Meta-Analysis

The optimal endovascular therapy for vein graft stenosis (VGS) following infrainguinal arterial bypass is yet to be established. Drug-coated balloons (DCB) have rapidly improved the inferior patency outcomes of angioplasty using a conventional plain balloon (PB). This study compares the efficacy of DCBs and PBs for the treatment of infrainguinal VGS. This systematic review and meta-analysis was performed according to the PRISMA statement. Multiple electronic searches were conducted in consultation with a health science librarian in September 2022. Studies describing the comparative outcomes of angioplasty using DCBs and PBs in the treatment of infrainguinal VGS were eligible. Datasets from one randomized controlled trial and two cohort studies with a total of 179 patients were identified. The results indicated no significant difference in target lesion revascularization between DCBs and PBs (OR, 0.64; 95% CI, 0.32-1.28; p = 0.21), with no significant heterogeneity between studies. Additionally, differences in primary patency, assisted primary patency, secondary patency, and graft occlusion were not significant. Subgroup analysis showed similar effects for different DCB devices. In conclusion, DCBs showed no significant benefit in the treatment of VGS compared to PBs. Given the small population size of this meta-analysis, future trials with a larger population are desired.

Abstract 13394: Primary Perfusion Balloon Angioplasty in Primary Percutaneous Coronary Intervention for St-Segment Elevation Myocardial Infarction - The Novel Cardioprotective Revascularization Strategy

Background: In patients with STEMI, primary PCI reduces the risk of cardiovascular death, whereases following myocardial reperfusion injury indicating poor prognosis. Post-conditioning is expected to limit reperfusion infarction but the long-term outcome is unclear. We investigated whether primary perfusion balloon angioplasty (PPBA) strategy might reduce reperfusion injury and improve prognosis. Methods: PPBA is maneuver treating as primary revascularization procedure with perfusion balloon angioplasty undergoing long-inflation (5-minutes or more) as post-conditioning. This study is a retrospective analysis from an observational registry which enrolled all consecutive 49 patients with STEMI undergoing PCI in PPBA strategy or conventional balloon angioplasty (CBA) strategy at a single center from February 2021 to January 2022. The primary outcome of the study was MACE as a composite of all-cause death, cardiac death, MI, CI-TVR, hospitalization because of heart failure, and cerebrovascular disease followed at 6 months. The secondary outcome was the composite of no-reflow or slow flow phenomenon, ST elevation, and VT or VF occurrence immediately after primary revascularization procedure. Results: 24 patients were treated with PPBA strategy and 25 patients were treated with CBA strategy. At the 6-months, primary composite outcome occurred in 25% treated with PPBA strategy and in 52% treated with CBA strategy (HR, 0.38; P=0.04); the difference was driven by a lower incidence of cardiac death, MI, CI-TVR in PPBA arm. Immediately after primary revascularization, secondary composite outcome occurred in 4.2% treated with PPBA and in 56% treated with CBA (RR, 0.03; P=0.0001); the difference was driven by a lower incidence of no-reflow/slow flow and ST elevation in PPBA arm. Conclusions: PPBA strategy as primary cardioprotective revascularization expected post-conditioning reduces lethal reperfusion injury, resulting in a better prognosis in STEMI.

GSOR5 Presentation Time: 9:20 AM: Balloon Intravaginal Packing Reduces Rectal Dose and Toxicity in Brachytherapy for Cervical Cancer

<h3>Purpose</h3> To compare differences in normal tissue toxicity between conventional gauze vs. balloon intravaginal packing in women receiving brachytherapy for cervical cancer. <h3>Materials and Methods</h3> We retrospectively identified women with 2009 FIGO stage IB1-IVB cervical cancer who received definitive EBRT with cisplatin and T&O or T&R brachytherapy between 2010-2016 at our institution. The primary endpoints were rates of grade ≥2 vaginal, GU, and GI toxicity. Dose metrics were compared via the Mann-Whitney U test. Toxicity rates were estimated via the Kaplan-Meier method and compared via log-rank test, and factors associated with toxicity were identified with Cox regression analysis. <h3>Results</h3> 96 patients received brachytherapy with a median follow-up of 39 months. 32 patients received intravaginal gauze packing, while 64 patients received intravaginal balloon packing. Two balloon leakages occurred and were replaced with gauze packing for that fraction. Gauze packing was associated with significantly higher rectal D2cc vs. balloon packing (median 66 Gy gauze vs. 55 Gy balloon, p<0.01), but not with vaginal or bladder D2cc. As shown in the figure, on Kaplan-Meier analysis, gauze packing was also associated with higher rates of grade ≥2 vaginal toxicity vs. balloon packing (3-year rate 30.1% vs. 20.0%, p<0.05), GU (32.2% vs. 11.3%, p<0.05), and GI (42.3% vs. 18.4%, p<0.05) toxicity. Grade ≥3 vaginal (3-year rate 11.9% vs. 5.5%, p<0.05) and GI (21.0% vs. 4.8%, p<0.05) toxicity was also higher with gauze vs. balloon packing. On multivariate Cox regression analysis, gauze packing remained significantly associated with grade ≥2 vaginal toxicity (HR 5.15, 95% CI 1.41-18.85, p<0.05), but not with GU or GI toxicity. <h3>Conclusions</h3> Compared to conventional gauze packing, intravaginal packing balloons were associated with reduced rectal D2cc and late GI toxicity. Decreased rates of late vaginal and GU toxicity were also observed, though corresponding D2cc metrics were not significantly reduced.

Use of a Cutting Balloon Dilation as a Rescue Therapy in Patients with Benign Bilioenteric Anastomotic Strictures Refractory to Conventional Balloon Dilation

Use of a Cutting Balloon Dilation as a Rescue Therapy in Patients with Benign Bilioenteric Anastomotic Strictures Refractory to Conventional Balloon Dilation

Drug-Coated Balloon Angioplasty for Carotid Artery In-Stent Restenosis: Case Series

Objectives: Few case reports have demonstrated promising results of drug-coated balloons (DCBs) as an emerging management for carotid artery in-stent restenosis (CAISR). Herein, we report 6 cases of CAISR which were treated with a DCB with or without new stent deployment. Background: Carotid artery in-stent restenosis is a high-risk condition with an estimated incidence rate that varies widely from 6% to 40%. Several strategies are available now for the management of the CAISR including conventional balloon angioplasty, plaque modification balloon angioplasty, and new stent placement. Methods: A retrospective review of consecutive patients with a diagnosis of severe CAISR at Baylor Scott & White The Heart Hospital Plano from 2011 to 2021 was performed. This study was approved by the Baylor Scott & White Research Institute institutional review board. Results: Six patients underwent DCB angioplasty with or without stent placement under an embolic protection device. Resolution of CAISR was achieved in all cases with 0% to 10% residual stenosis in all cases. Following the procedure, 1 patient had a brief episode of syncope with balloon inflation with immediate recovery on deflation of the balloon. There were otherwise no significant neurological or cardiac events prior to discharge. All patients were asymptomatic at their follow-up visit with no neurological or cardiac events reported at 12, 24, and 36 months following the procedure. Conclusion: While CAISR treatment remains a challenging condition, our study shows that the use of DCB with or without stent placement is a feasible and promising treatment option when compared with other conventional treatment options. Clinical Impact Carotid artery in-stent restenosis treatment remains a challenging condition. Our study shows that the use of drug coated balloon with or without stent placement is a feasible and promising treatment option when compared with current conventional treatment options.

“Investment technique” for improving recanalization of a coronary chronic total occlusion with conventional and drug-coated balloons: the IMPROVED–CTO registry

Chronic total occlusion plaque modification (CTO-PM) is often used after unsuccessful CTO interventions to facilitate future attempts. We aimed to explore the safety and efficacy of both conventional (CB) and drug-coated balloons (DCB) for CTO-PM.

Impact of Chocolate percutaneous transluminal angioplasty balloon on vessel preparation in drug-coated balloon angioplasty for femoropopliteal lesion

PurposeTo compare the impact of Chocolate and conventional balloons on vessel preparation in percutaneous transluminal angioplasty.Materials and methodsThis single-center retrospective study included 111 endovascular therapy consecutive cases of femoropopliteal lesions using drug-coated balloon strategy with a 1:1 pre-dilation balloon diameter between February 2020 and August 2021, divided into the Chocolate percutaneous transluminal angioplasty (n = 48) and conventional (n = 63) groups. Before the availability of Chocolate balloons in Japan (December 2020), a standard semi-compliant or non-compliant balloon was used for vessel preparation. The primary endpoint was rate of severe dissection after pre-dilatation. Secondary endpoints were angiographic percent diameter stenosis, bailout stent rate, primary patency rate, and freedom from target-lesion-revascularization rate at six months.ResultsThere was no significant difference in patient and lesion characteristics. The procedural characteristics comprised balloon length 90 ± 37 and 149 ± 95 mm (P = 0.004) and inflation pressure 11 ± 3 and 16 ± 7 atm (P < 0.001) in the Chocolate and conventional groups, respectively. Regarding primary endpoint, rates of severe dissection were 4.2% and 25% (P = 0.003); regarding secondary endpoints, percent diameter stenosis was 18 ± 15% and 20 ± 17% (P = 0.409), and the rate of bailout stenting was 2.1% and 15.9% (P = 0.016) in the Chocolate and conventional groups, respectively. The primary patency rates at six months were 89.1% and 85.2% (P = 0.670), and freedom from target-lesion-revascularization rate at six months was 100% and 92.8% (P = 0.691) in the Chocolate and conventional groups, respectively.ConclusionChocolate percutaneous transluminal angioplasty balloons reduce the rate of severe dissection while maintaining a sufficient dilatation effect during drug-coated balloon vessel preparation.

A novel soft cardiac assist device based on a dielectric elastomer augmented aorta: An in vivo study.

Although heart transplant is the preferred solution for patients suffering from heart failures, cardiac assist devices remain key substitute therapies. Among them, aortic augmentation using dielectric elastomer actuators (DEAs) might be an alternative technological application for the future. The electrically driven actuator does not require bulky pneumatic elements (such as conventional intra-aortic balloon pumps) and conforms tightly to the aorta thanks to the manufacturing method presented here. In this study, the proposed DEA-based device replaces a section of the aorta and acts as a counterpulsation device. The feasibility and validation of in vivo implantation of the device into the descending aorta in a porcine model, and the level of support provided to the heart are investigated. Additionally, the influence of the activation profile and delay compared to the start of systole is studied. We demonstrate that an activation of the DEA just before the start of systole (30 ms at 100 bpm) and deactivation just after the start of diastole (0-30 ms) leads to an optimal assistance of the heart with a maximum energy provided by the DEA. The end-diastolic and left ventricular pressures were lowered by up to 5% and 1%, respectively, compared to baseline. The early diastolic pressure was augmented in average by up to 2%.

Use of a Cutting Balloon Reduces the Incidence of Distal Embolism in Acute Coronary Syndrome Requiring Predilatation Before Stenting.

Background: Acute coronary syndrome (ACS) patients with solid lesions often require predilatation before stenting. Predilatation with high pressure may increase the risk of distal embolism, whereas direct stenting increases the risk of stent underexpansion. We recently reported that, in severely calcified lesions, using a cutting balloon (CB) can provide greater acute gain compared with other scoring balloons. Therefore, we hypothesized that predilatation with CB may reduce the incidence of distal embolism in ACS patients with solid lesions.Methods and Results: This study retrospectively analyzed data for 175 ACS patients who required predilatation, either with a conventional balloon (n=136) or CB (n=39). The occurrence of distal embolism was significantly lower in the CB than conventional balloon group (10.3% vs 32.4%, respectively; P=0.007). Multivariate analysis showed that the occurrence of distal embolism was positively associated with Thrombolysis in Myocardial Infarction (TIMI) grade and the presence of attenuated plaque, but negatively associated with the use of a CB. To support this clinical observation, we compared thrombus dispersal using a CB and non-compliant balloon in an ex vivo experimental model using a pseudo-thrombus. In this model, pseudo-thrombus dispersal was significantly smaller when a CB rather than non-compliant balloon was used (1.8±1.0% vs 2.6±1.2%, respectively; n=20, for each; P=0.002).Conclusions: In ACS patients with solid lesions that require predilatation, predilatation with a CB may reduce the incidence of distal embolism.

A prospective, multi-center, randomised controlled trial for evaluation of the effectiveness of the Blimp scoring balloon in lesions not crossable with a conventional balloon or microcatheter: the BLIMP study

Background Balloon uncrossable coronary lesions are lesions that cannot be crossed with a conventional balloon. Multiple balloons have been designed to overcome this problem. The Blimp balloon has a very low scoring profile (0.6 mm) with a very high rated burst pressure (30 atmospheres). We aimed to evaluate the efficacy of this balloon compared to customary low-profile balloons. Methods We conducted a multicenter, prospective, randomised, controlled trial in which 126 patients with an uncrossable lesion were randomly (1:1 randomization) assigned to treatment first with the Blimp balloon or low-profile balloon. The primary endpoint was the success of crossing the lesion after initial failure with a microcatheter (group A) or with a conventional balloon (group B). Results Overall, the first attempt of Blimp was successful in 29 out of 61 cases (48%) while the LP balloon immediately crossed in 30 out 67 cases (45%; p = 0.761). Using a low-profile balloon in the BLIMP group after failure of the Blimp balloon increased the success to 64% (39 out of 61 cases). Using the Blimp balloon in the low-profile first group after failure of the low-profile balloon increased the success to 60% (40 out of 67 cases). After the placement of a guide catheter extension, the overall successful lesion crossing in the BLIMP group was 80% (49 out of 61 cases) compared to 76% (51 out of 67 cases) in the LP Balloon group (p = 0.327). Conclusions The Blimp balloon catheter showed no superiority to customary low-profile balloons in uncrossable lesions. It can however be complementary in treating uncrossable lesions.

Use of a Cutting Balloon Dilation as a Rescue Therapy in Patients with Benign Bilioenteric Anastomotic Strictures Refractory to Conventional Balloon Dilation

Percutaneous balloon dilation with or without placement of an external biliary drain is a nonoperative alternative method for treating benign bilioenteric anastomotic strictures. Although this procedure has a high technical success rate, outcomes are less optimal when attempting to dilate refractory tight strictures. For the stricture, cutting balloon can be an option. We present four patients with benign bilioenteric anastomotic strictures refractory to conventional balloon dilation. To the patients, a peripheral cutting balloon over-the-wire system was inflated, following subsequent conventional non-compliant balloon dilation. After the balloon dilation treatment, an external drainage catheter was placed through the stricture site and maintained for up to 30 days. Technical and end-treatment success was achieved in all four patients. In conclusion, the use of cutting balloon dilation may appear to be a safe and effective alternative method of treatment in patients with benign bilioenteric anastomotic strictures refractory to conventional balloon dilation.

A prospective randomized trial of the use of drug-eluting balloon catheters for the treatment of a lateral branch in patients with true bifurcation lesions

Background. Endovascular interventions for bifurcation lesions of the coronary arteries account for approximately 15-20% of all coronary interventions. Despite the use of drug-eluting stents, the management of bifurcation lesions remains challenging, especially in the setting of lateral branch involvement. Although the Provisional stenting strategy is the preferred method for most patients, several studies have shown that dual-stent techniques may be advantageous in this patient population. However, as a general approach, the European Bifurcation Club recommends that percutaneous coronary interventions be performed with a minimum number of stents.Aim. To evaluate the safety and efficacy of using a paclitaxel-coated balloon in the treatment of a lateral branch in patients with true bifurcation coronary disease.Methods. This work was performed as a result of a clinical analysis and evaluation of the results of treatment of 80 patients with coronary artery disease, who underwent stenting of a true bifurcation lesion in the period from 2020 to 2021. All patients were randomized in a 1:1 ratio to main branch stenting followed by lateral branch dilatation with drug-eluting balloons and provisional stenting. A direct angiographic analysis was carried out before and after the intervention, and control coronary angiography was performed 12 months later with an assessment of the results obtained. All patients underwent a comprehensive clinical, laboratory and instrumental examination.Results. Pre-procedure reference main branch diameters were 2.97 ± 0.41 mm and 3.12 ± 0.38 mm in the Provisional and drug-eluting balloons groups, respectively. The degree of stenosis of the main branch before percutaneous coronary interventions was 65.2 ± 14.1% and decreased to 13.3 ± 6.6% after intervention in the Provisional stenting group. This was comparable to the results of percutaneous coronary interventions in the group of patients who used drug-eluting balloons 63.8 ± 12.3% and 12.9 ± 5.8%, respectively. The minimum diameter of the main branch after percutaneous coronary interventions increased from 1.04 ± 0.34 mm to 2.72 ± 0.44 mm in the Provisional stenting group and subsequently decreased to 2.18 ± 0.33 mm, according to control coronary angiography after 12 months. At the same time, patients who underwent intervention using drug-eluting balloons had a smaller loss of the lumen of the main branch 0.41 ± 0.33 mm versus 0.63 ± 0.32 mm (p = 0.003). In addition, late loss of lumen both in the lateral branch (0.51 ± 0.22 mm versus 0.33 ± 0.24 mm) and total in both branches of the bifurcation (1.06 ± 0.29 mm versus 0.79 ± 0.27 mm) was statistically greater with Provisional stenting.Conclusion. Treatment of bifurcation lesions using the Provisional technique with drug-eluting lateral branch dilatation has shown better results than with conventional balloons.

Cost-Effectiveness of Drug-Coated Balloon Angioplasty Compared With Conventional Balloon Angioplasty for Arteriovenous Access Flow Dysfunction

ObjectivesThis study aimed to determine the cost-effectiveness of drug-coated balloon (DCB) angioplasty compared with conventional balloon angioplasty (cPTA) in patients with arteriovenous fistulas (AVFs) and arteriovenous grafts (AVGs) dysfunction from a Singapore healthcare perspective. MethodsExisting cost-effectiveness studies comparing DCB and cPTA have not incorporated AVF/AVG abandonment costs. This Markov model-based economic evaluation incorporated AVF/AVG creation and maturation costs on top of routine intervention costs to model a hypothetical cohort of 60-year-old AVF/AVG flow dysfunction patients. Effectiveness was measured in quality-adjusted life-years. Cost-effectiveness was assessed using incremental net monetary benefit (NMB) at a Singapore willingness-to-pay threshold of Singapore dollar (S$)87 000. Deterministic and probabilistic sensitivity analyses were performed to examine parameter uncertainty. To test hypotheses regarding cost-effectiveness, intervention counts per patient, cumulative incidence functions of AVF/AVG abandonment, and survival curves of death were compared between DCB and cPTA. ResultsDCB was not cost-effective at 3-year horizon (NMB = −S$1424), but was cost-effective at 1- and 6-year horizons (NMB = S$356 and S$3738, respectively). At 3 years, there was a 34.5% probability of DCB being cost-effective, but at 1- and 6-year horizons there was, respectively, 58.6% and 59.9% probability of DCB being cost-effective. DCB had graphically less AVF/AVG-abandonments, but this was not statistically significant (P = .21). Differences in other parameters were neither graphically nor statistically significant. ConclusionsWith AVF/AVG abandonment considered, DCB may be weakly cost-effective compared with cPTA in treating AVF/AVG flow dysfunction. AV access creation and maturation costs could have important explanatory value in assessing DCB cost-effectiveness.

Comparison of Primary Patency Rate between Drug- Coated Balloon and Plain Balloon Angioplasty in Hemodialysis Access

Objective: Hemodialysis adequacy in end-stage renal disease patients plays a crucial role in their quality of life. Repeated stenosis at the anastomotic site of arteriovenous fistula and synthetic arteriovenous graft are a major cause of access failure resulting in hospitalization, catheter usage, and contributing substantially to increased health care costs. Although standard plain balloon angioplasty (PBA) is successful, the patency rate over time is often poor. Drug-coated balloons (DCB) delivering an anti-restenosis agent, Paclitaxel, may improve patency. In this study, we aimed to investigate whether there is an increase in primary patency rate in drug-coated balloon angioplasty compared to conventional plain balloon angioplasty.Materials and Methods: We performed a retrospective analysis of 55 patients with stenotic arteriovenous fistulas (AVF), and arteriovenous grafts (AVG) treated with DCB or PBA. Thirty-five patients were treated with drug-coated balloons, while twenty patients were treated with the standard plain balloon angioplasty. Follow up assessment was scheduled at three months, six months, and nine months. Our primary outcome was the primary patency rate, defined as the interval from the time of intervention until hemodialysis inadequacy.Results: There were 55 patients including twenty-one males and thirty-four females participated in the study. The average age of the 55 patients was 65.43 ± 12.89 years. Thirty (54.5%) patients were diabetes mellitus and 40 (72.7%) patients had hypertension. Seven patients (12.7%) had dyslipidemia. Eight patients (14.5%) had ischemic heart disease. And four patients (7.3%) had hyperparathyroidism. No significant differences in patency rate were found between gender, age group and patients’ underlying diseases. The proportion of primary patency rate comparing between the DCB and PBA treatment was 96.3% versus 73.9% at 6 months (P=0.017) and 92.6% versus 40% at 9 months (P&lt;0.001). After multivariable analysis was performed (adjusted for sex, age, and underlying diseases), we found that stenosis was more likely to occur in patients who had undergone plain balloon angioplasty rather than drug-coated balloon angioplasty (HR 15.75; 95% CI 2.5%-99.1%, P=0.003).Conclusion: Drug-coated balloon angioplasty, when compared with plain balloon angioplasty, achieves a more desirable primary patency rate at 6 months and 9 months after the procedure.

Characteristics and effects of a new Atom uterine hemostatic balloon for postpartum hemorrhage: First experience of 17 cases

Uterine balloon tamponade is the first-line treatment for postpartum hemorrhage (PPH). However, as cases accumulate, the disadvantages of conventional balloons, such as difficulties with insertion, displacement, dislodgement, slipping outside, and occlusion of the drainage tube with blood clots, have become evident. The newly developed Atom uterine hemostatic balloon has a stylet designed as an insertion guide for smooth insertion. The end of the insufflation portion can be housed in the handle tip of the stylet inserted into the other drainage tube to facilitate retrograde insertion of the balloon and prevent damage to the cervical canal during cesarean section. This balloon was designed in the shape of an apple to prevent it from slipping off. A drainage port without projections was used to improve adhesion to the uterine luminal wall.

Abstract No. 203 Drug-coated balloon angioplasty versus conventional balloon angioplasty for arteriovenous fistula stenosis: a cost effectiveness study

Abstract No. 203 Drug-coated balloon angioplasty versus conventional balloon angioplasty for arteriovenous fistula stenosis: a cost effectiveness study