Drug-Coated Balloons: Hope or Hot Air: Update on the Role of Coronary DCB.

PURPOSE OF REVIEW: The present manuscript reviews the mechanism of action of drug-coated balloons (DCBs), offering a brief summary of the main clinical evidence on these devices. RECENT FINDINGS: DCBs are regular semi-compliant balloons coated with antiproliferative agents that are rapidly released on contact with the vessel intima, exerting an anti-restenotic effect. This technology may offer some benefits of drug-eluting stents, in particular for the treatment of restenotic lesions, small vessels, and in patients at high-bleeding risk, when the prolonged dual antiplatelet regimen should be avoided. Most recent data have pointed to a possible benefit of these devices in treating bare metal stents (BMS) or drug-eluting stents in-stent restenosis (DES ISR), effectively reducing the recurrence of restenosis and avoiding additional layers of metal in the same coronary segment. In other clinical scenarios such as bifurcations, small vessels, and de novo lesions, data is more scarce and the benefits are still unclear. There are potential benefits related to the use of DCB in selected populations. However, larger clinical trials with longer follow-up are still needed to confirm the enthusiastic initial results.

Arterite de Takayasu e ulceração no couro cabeludo em mulher com 24 anos etários / Takayasu?s arteritis and ulceration of the scalp in a 24-year-old woman

O objetivo é descrever dados clínicos e de imagem em mulher de 24 anos com arterite de Takayasu, que apresentou extensa ulceração de difícil controle no couro cabeludo. Houve acometimento da pele, do tecido subcutâneo, de músculos e ossos parietais subjacentes. A paciente relatou fraqueza nos membros superiores, mais intensa à esquerda, e isquemia intermitente nas quatro extremidades. Ao exame, havia ausência bilateral de pulsos braquiais, radiais e ulnares. Os pulsos tibiais posteriores e pediosos tinham suas amplitudes diminuídas. Constatou-se pressão arterial de 86 por 54 mmHg no braço esquerdo e 100 por 62 mmHg no direito. A associação de arterite de Takayasu com ulceração cutânea é incomum, em especial no couro cabeludo, e deve ser considerada a dermatose pustulosa erosiva como diagnóstico diferencial dessa condição.

The aim is to describe clinical and imaging data of a 24-year-old woman with Takayasu?s arteritis and presenting an extensive ulceration of difficult control in the scalp. There was involvement of the skin and subcutaneouslayer, in addition to the subjacent muscles and parietal bones. The patient claimed of weakness on the upper limbs more intense at the left, and intermitent ischemia in all the extremities. Physical examination showed bilateral absence of brachial, radial, and ulnar pulses, and posterior tibial and dorsalis pedis pulses had reduced amplitudes. Blood pressure levels were 86/54 mmHg on the left arm and 100/62 mmHg on the right arm. Association between Takayasu?s arteritis and skin ulcers is uncommon, in special on the scalp, and erosive pustular dermatosis must be considered as a differential diagnosis of this condition.