Background: The usefulness of drug-eluting balloons (DEBs) has not been fully elucidated in calcified coronary lesions (CCLs). This meta-analysis aimed to evaluate the efficacy of DEBs compared to a drug-eluting stent (DES) in this setting. Methods: PubMed, EMBASE and Cochrane were searched through December 2023. The primary endpoint was 12 months major adverse cardiac events (MACE). Secondary endpoints included clinical outcomes and angiographic results after PCI and at a 12-month follow-up. Results: Five studies and a total of 1141 patients with 1176 coronary lesions were included. Overall, the DEB was comparable to DES in MACE (RR = 0.86, 95% CI: 0.62–1.19, p = 0.36), cardiac death (RR = 0.59, 95% CI: 0.23–1.53, p = 0.28), myocardial infarction (RR = 0.89, 95% CI: 0.25–3.24, p = 0.87) and target lesion revascularization (RR = 1.1, 95% CI: 0.68–1.77, p = 0.70). Although the DEB was associated with worse acute angiographic outcomes (acute gain; MD = −0.65, 95% CI: −0.73, −0.56 and minimal lumen diameter; MD = −0.75, 95% CI: −0.89, −0.61), it showed better results at 12 months follow-up (late lumen loss; MD = −0.34, 95% CI: −0.62, −0.07). Conclusions: This meta-analysis showed that the DEB strategy is comparable to DES in the treatment of CCLs in terms of clinical outcomes. Although the DEB strategy had inferior acute angiographic results, it may offer better angiographic results at follow-up.

High-risk pulmonary embolism (PE) is a serious and potentially fatal condition in pregnant and postpartum women. Clinical practice guidelines recommend managing high-risk PE in the general population with systemic thrombolysis as the first therapeutic option. However, pregnant and especially early postpartum women may have a high risk of bleeding that contraindicates this therapy. In this regard, dedicated percutaneous large-bore aspiration catheters may be a promising alternative for this population. We present 2 cases of pregnant women diagnosed with high-risk PE and an absolute contraindication to systemic thrombolysis, successfully treated with percutaneous mechanical thrombectomy using a dedicated large-bore aspiration catheter. There were no complications, and both patients were discharged with full recovery and subsequently had uncomplicated deliveries. Clinical Impact: Through these clinical cases, we present a new protocol of action, updated with the latest evidence on percutaneous pulmonary thrombectomy using dedicated catheters, for high-risk PE in pregnant women or during the early postpartum period.

Subacute massive pulmonary embolism is an uncommon manifestation of severe pulmonary embolism associated with poor prognosis. Given the chronicity of the thrombi, standard medical treatment may not be effective. We present a case where mechanical thrombectomy using thromboaspiration catheter was effective, resulting in clinical improvement following the extraction of a large amount of thrombus. Clinical Impact: Mechanical thrombectomy using a thromboaspiration catheter can be an effective alternative in the treatment of subacute pulmonary embolism.