Drug-Coated Balloon After Intravascular Lithotripsy: Procedural and Clinical Outcome of the "Crack and Drug" Strategy
Authors' conclusion
In calcified coronary lesions, DCB after IVL demonstrates excellent efficacy and safety, achieving high technical success with low device-dependent adverse event rates.
Study context
- Population
- Patients undergoing PCI with intravascular lithotripsy (IVL) for balloon-crossable calcified coronary lesions45 (7.8%) DCB
- Participants
- 579 patients
- Exposure
- IVL + DCB vs IVL + DES
- DCBn = 45
- Outcome
- Procedural success (IVL catheter crossing with residual stenosis <30%, final TIMI flow grade 3, and no in-hospital MACE)
Methodological detailsBENELUX-IVL registry
- BENELUX-IVL registry
Main finding
As reported in the abstract
Procedural success · in-hospital
- Procedural success comparable between the 2 strategies (89.4% vs 91.7%; abstract does not state which value belongs to which group)
- P = 0.55
Observational data: associations, not effects.
Further findings
Chronic total occlusions
P < 0.01
In-stent restenosis lesions
P < 0.01
Safety
In-hospital major adverse cardiac events (MACE) (primary safety endpoint)
- In-hospital MACE comparable between the 2 strategies (0% vs 2.1%; abstract does not state which value belongs to which group)
- P = 0.33
Intraprocedural complications
- Low, no significant difference between DES and DCB (8.9% vs 5.8%)
- P = 0.41
Bailout DES implantation
- No bailout DES implantation required with DCB
Original publication
Drug-Coated Balloon After Intravascular Lithotripsy: Procedural and Clinical Outcome of the "Crack and Drug" Strategy. JACC Adv. Published 24 October 2025. doi:10.
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