Session 3 - BBRAUN - Why Malaysia embraced DCB early on... – Mohd Ali Rosli

Introduction to the Study in Malaysia

Background and Initial Meeting

• The speaker introduces their disclosure slides, recounting a meeting with Dr. Paul Raj and Dr. Michael Boxwagen in Malaysia.

• The discussion references significant studies from 2006, including Bruno's publication in the New England Journal and Martinovven's presentations at TCT 2007.

Study Proposal and Execution

• A physician-initiated study was proposed to compare bare metal stents with drug-coated balloons (DCB) for treating de novo diabetic lesions.

• Recruitment challenges were faced due to the long-standing nature of diabetes among patients; however, the study was completed successfully by January 2009.

Study Findings and Impact

Results Overview

• The study found no significant difference in late lumen loss between DCB and bare metal stents, with results showing 0.51 vs. 0.53 respectively.

Contributions to Research

• Malaysia participated in various studies, including first-in-man trials comparing different types of coated balloons for treating DSISR.

Adoption of Drug-Coated Balloons

Early Adoption Challenges

• Early adopters faced difficulties convincing colleagues about DCB usage; however, training centers played a crucial role in promoting its use.

Long-term Patient Outcomes

• A case is shared about a diabetic patient treated with a drug-eluting stent who experienced positive outcomes over several years.

Knowledge Sharing and Consensus Reports

Dissemination of Knowledge

• Efforts were made to propagate DCB technology through conferences like Malaysia Live and Asia PCR, sharing experiences internationally.

Contribution to Consensus Reports

• The Malaysian team contributed significantly to two Asia-Pacific consensus reports on cardiovascular practices published this year.

National Cardiovascular Registry Insights

Data Analysis from PCI Cases

• Insights from the Malaysian National Cardiovascular Registry indicate an increasing number of procedures performed over recent years.

Demographics and Lesion Characteristics

Current Trends in Drug-Coated Balloons

Overview of Usage Trends

• The use of drug-coated balloons (DCBs) has significantly increased, with projections indicating that approximately 45% of devices used this year will be DCBs.

• DCBs are primarily utilized for treating single vessel disease, while they are also applied in one out of four cases involving multiple vessel disease.

Hospital Experience and Data

• In the current year, up to September, the usage of drug-eluting stents is below 40%, with DCBs being employed alongside these stents in hybrid procedures.

• Pure DCB usage has reached about 15%, contributing to a total utilization rate of around 60% among patients treated at the hospital.

Implementation Strategy

• The introduction and adoption of DCB technology were driven by collaborative trials and a strong scientific foundation, emphasizing the importance of proper training and exposure to new technologies.