Difference between drug-eluting balloon and stent

Many friends will ask about the difference between drug-eluting balloons and stents. Which one is better? In fact, this depends on the individual's condition. Some patients are suitable for drug-eluting balloons, while others are suitable for stents. It is recommended to choose treatment under the guidance of a professional doctor. If the balloon can expand smoothly, it is recommended not to place a stent, because the stent will feel like a foreign body after all.

1. Two basic functions of the balloon:

1. Balloon pre-dilatation facilitates the smooth placement of subsequent stents:

2. Post-dilatation of the balloon ensures that the stent is fully expanded or well adhered to the wall.

There are many types of balloons, which can be divided into Over the Wire (OTAw) according to their usage characteristics.

Rapid exchange

system, and the balloon on the guidewire

There are three types of balloons: specially designed balloons such as perfusion balloons, cutting balloons, double-wire focusing balloons, and drug-loaded balloons. According to the diameter of the balloons, they can be roughly divided into small balloons (2-5mm), ordinary balloons (5N 12mm), and large balloons (≥12mm).

Small balloons are generally used for coronary arteries, tibial and peroneal arteries below the popliteal artery, and renal and vertebral arteries with relatively small diameters;

Ordinary balloons are generally used for the carotid artery, renal artery, iliac-femoral-popliteal artery, etc., while large balloons are generally used for the infrarenal abdominal aorta, iliac artery and vena cava, etc.

The performance indicators for evaluating balloon catheters generally include balloon outer diameter, tracking, pushability, flexibility and compliance.

2. Related classification of stents

There are many classification standards for peripheral vascular stents. Based on the stent release method, they can be divided into balloon-expandable stents and self-expanding stents; based on the function and treatment goal of the stent, they can be divided into bare metal stents (BMS), drug coated stents, and covered stents.

stent)：

According to the structural design of the bracket, it can be divided into slotted-tube bracket

stent, annular stent and coil stent

stent);

According to the different mesh sizes of the bracket, it can be divided into closed-loop bracket and open-loop bracket.

The metal skeleton material of the stent is generally stainless steel wire, tantalum wire, temperature-controlled nickel-titanium alloy, cobalt-chromium alloy, etc.

Ball-expandable stent:

The balloon-expandable stent itself is inelastic. It is designed so that the stent is pre-installed on a balloon and delivered to the site of vascular lesions via a balloon catheter. After the balloon expands to the intended diameter, it adheres to the vessel wall by relying on the retraction force of the vessel wall and does not generate continuous expansion tension on the vessel wall. The biggest advantage of the balloon-expandable stent is its precise positioning during release, which makes it particularly suitable for ostial lesions, such as vertebral artery ostium and renal artery ostium lesions. In addition, it has the characteristics of no obvious shortening after release and stronger radial support force than peripheral self-expanding stents.