Non-invasive and Intravascular Identification and Drug-Eluting Balloon Treatment of Vulnerable Lipid-Rich Plaques: DEBuT-LRP

The DEBuT-LRP project was a collaborative public-private partnership between Amsterdam UMC, BBraun, and Infraredx, aimed at improving cardiovascular outcomes by targeting vulnerable coronary plaques. The project combined advanced intracoronary imaging, localized treatment, and artificial intelligence to identify and stabilize high-risk lipid-rich plaques in coronary arteries. The collaboration focused on developing novel strategies to prevent future cardiac events by targeting the underlying causes of acute coronary syndromes (ACS).

Cardiovascular disease is the leading cause of death worldwide, responsible for nearly 18 million deaths annually. In the Netherlands, more than 100,000 people are hospitalized each year due to heart-related conditions. Despite current therapies, approximately 30% of patients experience a recurrent coronary event within five years. Most ACS events are caused by the rupture or erosion of lipid-rich plaques—features that are not always detectable with standard diagnostics—highlighting the need for improved detection and intervention strategies.

In the DEBuT-LRP project, vulnerable plaques were identified using advanced intracoronary imaging techniques and were locally treated with drug-coated balloons, which delivered medication directly to the plaque without leaving a permanent implant. In parallel, AI-based algorithms were developed to enable non-invasive detection of lipid-rich plaques using coronary CT scans. This combined approach aimed to support earlier risk identification and targeted prevention.

This first-in-human study demonstrated that local treatment with drug-coated balloons was safe and significantly reduced lipid plaque burden after nine months follow-up. No major procedure-related complications were observed. In addition, the development of the AI models enable broader and earlier identification of high-risk plaques in the future. In conclusion, the outcomes of the DEBuT-LRP project have laid the foundation for further clinical studies in both interventional and diagnostic strategies to improve the prevention of recurrent acute coronary events.