by Drug Eluting Balloon is an innovative medical technology that helps in minimizing the chances of reblockages of arteries and improves overall blood circulation in the body. It is increasingly being used by cardiologists as an effective treatment option for peripheral artery disease. In this article, we will discuss what is a Drug Eluting Balloon, how it works, its benefits over other treatment methods and the future scope of this emerging technology.
What is a Drug Eluting Balloon?
A Drug Eluting Balloon, as the name suggests, is a small deflated medical balloon coated with an anti-proliferative drug. Some commonly used drugs include paclitaxel and limus family drugs. When inflated at the site of arterial blockage or narrowing, the drug gets transferred to the artery walls. The drug works by limiting cell proliferation and scar tissue formation at the treatment site, thereby reducing the chances of reblockage or restenosis.
Conventional angioplasty uses a standard balloon to widen the narrowed or blocked artery. However, restenosis remains a major limitation with bare metal balloons as the blood vessel often shrinks back to its original blocked state within months of the procedure. Drug Eluting Balloons were developed to overcome this limitation by delivering medication directly to the arterial walls.
How does a Drug Eluting Balloon work?
The procedure involves inserting a guide wire through an artery, usually in the groin area, and threading it up to the narrowed site. A Drug Eluting Balloon catheter integrated with the chosen drug is then inserted over the guide wire and positioned at the target site. The balloon is then inflated at high pressure to compress and flatten any plaque against the artery wall.
As the balloon inflates, the drug coating gets transferred and embedded into the arterial tissues. When the balloon deflates and is withdrawn, the drug elutes over time to prevent cell proliferation. This localized drug delivery at the angioplasty site prevents scar tissue formation and re-narrowing known as restenosis. The procedure takes around 30-60 minutes and does not require an open surgical procedure.
Benefits of Drug Eluting Balloons
Some key advantages of Drug Eluting Balloon angioplasty over conventional balloon angioplasty and other methods include:
– Lower restenosis rates: Drug Eluting Balloons significantly reduce the risk of restenosis by around 30-50% compared to bare metal balloons. This reduces the need for repeat procedures.
– No need for stents: Unlike drug eluting stents, balloons do not leave behind any permanent implant. This eliminates complications related to stents such as stent fractures.
– Shorter procedure time: Drug Eluting Balloon angioplasty has a much shorter procedure time compared to other endovascular procedures involving multiple devices.
– Cost effective: It provides comparable results to stenting at a lower overall cost due to reduced need for lifelong dual antiplatelet therapy and follow-up tests associated with stents.
– Applicable for various arteries: Balloon angioplasty is suitable for treating blockages in leg arteries as well as coronary, renal, and other vascular beds.
Applications of Drug Eluting Balloons
Based on the success of initial clinical studies, Drug Eluting Balloon usage has increased manifold in the last decade for treating various vascular conditions:
Peripheral Artery Disease: Also known as leg artery disease, it is the most common application of Drug Eluting Balloons. They help improve blood flow in the leg arteries and reduce symptoms like pain on walking.
Coronary Artery Disease: Some trials have shown Drug Eluting Balloons to be effective for treating blockages in heart arteries with outcomes comparable to drug eluting stents, without the complications.
In-Stent Restenosis: For patients who face re-narrowing or blockages developing inside metal stents (in-stent restenosis), Drug Eluting Balloons provide an effective solution with lower restenosis rates.
Venous Disease: Emerging research suggests they may also be useful for treating vein (venous) diseases affecting the leg veins by preventing scarring post angioplasty.
Future Possibilities
With the proven success of Drug Eluting Balloon technology, research is ongoing to expand its applications and enhance effectiveness. Some areas being explored include:
– Combination therapies: Using Drug Eluting Balloons along with newer generation drug eluting stents or bioresorbable stents/scaffolds to maximize outcomes.
– Gene eluting balloons: Infusing gene therapeutics instead of anti-proliferative drugs to impart longer term effects.
– Bioengineered coatings: Developing novel biodegradable polymer coatings for customized drug delivery profiles.
– Percutaneous renal denervation: Initial research indicates promise in reducing blood pressure by modulating renal nerves via drug coated balloons.
