2 The technology

Description of the technology

2.1 SeQuent Please (B Braun Medical) is a balloon catheter for percutaneous transluminal coronary angioplasty. The balloon is coated with the antimitotic drug paclitaxel, with the aim of reducing restenosis.

2.2 The balloon section of the catheter is coated with paclitaxel at a dose of 3 microgram/mm2. When the balloon is expanded, paclitaxel is released into the vessel wall. Using paclitaxel reduces smooth muscle cell proliferation that can give rise to restenosis and recurrence of symptoms. The aim of targeted delivery is to achieve a high local concentration of drug in the vessel wall with minimal systemic release. The balloon catheter is also coated in iopromide, an X-ray contrast medium which aims to improve the solubility and transfer of paclitaxel to the vessel wall. After treatment, antiplatelet therapy with clopidogrel is recommended for 3 months in addition to aspirin to reduce the risk of thrombosis.

2.3 The cost of a SeQuent Please balloon catheter is approximately £800 ± 150. The cost of SeQuent Please balloon catheter may vary because of differences in purchasing contracts.

Current management

2.4 Current treatment options for patients with in-stent restenosis include balloon angioplasty, repeat stenting (usually using a drug-eluting stent), cutting balloon angioplasty, directional coronary atherectomy, rotational coronary atherectomy and brachytherapy.

2.5 After implantation of a drug-eluting stent, antiplatelet therapy with clopidogrel and aspirin is usually continued for 12 months.

2.6 Various paclitaxel and other drug-eluting balloon catheters are available.

  • National Institute for Health and Care Excellence (NICE)