International Journal of General Medicine (Jan 2024)

Drug-Coated Balloon for de-novo Coronary Artery Lesions Exceeding 2.5 mm in Diameter: Optical Coherence Tomography Analysis and Clinical Follow-Up

  • Liu Y,
  • Zhang B,
  • Lv H,
  • Zhu Y,
  • Zhou X,
  • Zhu H,
  • Guo L

Journal volume & issue
Vol. Volume 17
pp. 225 – 236

Abstract

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Yuguo Liu,1 Bo Zhang,1 Haichen Lv,1 Yifan Zhu,2 Xuchen Zhou,1 Hao Zhu,1 Lei Guo1 1Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China; 2Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, People’s Republic of ChinaCorrespondence: Lei Guo; Hao Zhu, Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Dalian City, 116011, People’s Republic of China, Tel +86 411-83635963 ; +86 411-83635963, Email [email protected]; [email protected]: To investigate the precise changes in the lumen and lesions, and clinical outcomes after DCB treatment for de-novo coronary lesions exceeding 2.5 mm in diameter through a detailed analysis of OCT.Methods: This is a prospective study including 53 consecutive patients with 55 de-novo coronary lesions, who underwent DCB angioplasty-only between January 2021 and April 2022. Quantitative coronary angiography (QCA) and OCT were performed before percutaneous coronary interventions (PCI), immediately after PCI, and at 6– 9 months follow-up after PCI. Target lesion failure (TLF) was the primary endpoint of the present study. Multivariate logistic regression analysis was performed to identify the predictors or risks for late lumen enlargement (LLE).Results: A total of 52 patients were successfully treated with DCB. The median follow-up was 7 months, and the incidence of TLF was 7.5%. After the DCB procedure, 43 patients had their scheduled angiographic and OCT examination. QCA demonstrated that the late lumen loss was − 0.79 ± 0.28 mm. OCT demonstrated LLE in 79.1% and dissection healing in 65.1% of lesions. After multivariable logistic analysis, type B dissection (odds ratio [OR] 2.92, 95% confidence interval [CI] 1.34– 7.41, p = 0.037) was found to be a predictor of LLE, but lipid plaque (OR 0.09, 95% CI 0.01– 0.63, p = 0.015) was a risk of LLE.Conclusion: This is the first and largest prospective study to assess the outcomes of DCB treatment for de-novo coronary lesions exceeding 2.5 mm in diameter and the detection of significant vessel enlargement and dissection healing guide by OCT. DCB could be a novel, safe and effective treatment for de-novo coronary lesions exceeding 2.5 mm in diameter through a detailed analysis of OCT.Keywords: drug-coated balloon, optical coherence tomography, late lumen enlargement, de novo, coronary artery disease

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