Commentary: Dissection still a sticking point in the widespread use of DCB in PCI

Abstract

Dissection is judged as a major hurdle for a more widespread use of DCB

Vessel stretching by either overdilatation or by straightening of very tortuous vessel segments are the predominant avoidable or modifiable risk factors for major dissection during predilatation or during DCB application.

While aggressive (pre-)dilatation reduces the risk of elastic recoil, it increases the number of severe dissections. The known effects of positive vessel remodeling (1,2) might allow a more gentle angioplasty with residual stenosis of up to 30 % after DCB application without negative effects on long term results (3).