Impact of Dissection after Drug-Coated Balloon Treatment of De Novo Coronary Lesions: Angiographic and Clinical Outcomes

被引:18
作者
Hui, Lin [1 ,2 ]
Shin, Eun-Seok [1 ,3 ]
Jun, Eun Jung [1 ]
Bhak, Youngjune [4 ]
Garg, Scot [5 ]
Kim, Tae-Hyun [1 ]
Sohn, Chang-Bae [1 ]
Choi, Byung Joo [1 ]
Kun, Liu [2 ]
Yuan, Song Lin [1 ]
Zhi, Wang [2 ]
Hao, Jiang [2 ]
Shi Zhentao [2 ]
Qiang, Tang [2 ]
机构
[1] Ulsan Med Ctr, Div Cardiol, Dept Internal Med, 13 Wolpyeong Ro 171beon Gil, Ulsan 44686, South Korea
[2] Peking Univ, Shougang Hosp, Dept Cardiol, Beijig 100144, Peoples R China
[3] Univ Ulsan, Ulsan Univ Hosp, Div Cardiol, Dept Internal Med,Coll Med, Ulsan, South Korea
[4] Ulsan Natl Inst Sci & Technol UNIST, Dept Biomed Engn, Coll Informat Bioconvergence Engn, Ulsan, South Korea
[5] East Lancashire Hosp NHS Trust, Blackburn, Lancs, England
关键词
Balloon angioplasty; dissection; coronary heart disease; outcome research; ANGIOPLASTY; RESTENOSIS;
D O I
10.3349/ymj.2020.61.12.1004
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose: Dissection after plain balloon angioplasty is required to achieve adequate luminal area; however, it is associated with a high risk of vascular events. This study aimed to examine the relationship between non-flow limiting coronary dissections and subsequent lumen loss and long-term clinical outcomes following successful drug-coated balloon (DCB) treatment of de novo coronary lesions. Materials and Methods: A total of 227 patients with good distal flow (Thrombolysis in Myocardial Infarction flow grade 3) following DCB treatment were retrospectively enrolled and stratified according to the presence or absence of a non-flow limiting dissection. The primary endpoint was late lumen loss (LLL) at 6-month angiography, and the secondary endpoint was target vessel failure (TVF, a composite of cardiac death, target vessel myocardial infarction, target vessel revascularization, and target vessel thrombosis). Results: The cohort consisted of 95 patients with and 132 patients without a dissection. There were no between-group differences in LLL (90.8%) returning for angiography at 6 months (0.05 +/- 0.19 mm in non-dissection and 0.05 +/- 0.30 mm in dissection group, p= 0.886) or in TVF (6.8% in non-dissection and 8.4% in dissection group, p=0.799) at a median follow-up of 3.4 years. In a multivariate analysis, the presence of dissection and its severity were not associated with LLL or TVF. Almost dissections (93.9%) were completely healed, and there was no newly developed dissection at 6-month angiography. Conclusion: The presence of a dissection following successful DCB treatment of a de novo coronary lesion may not be associated with an increased risk of LLL or TVF (Impact of Drug-coated Balloon Treatment in de Novo Coronary Lesion; NCT04619277).
引用
收藏
页码:1004 / 1012
页数:9
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