Efficacy on the Acute Lumen Gain Post Excimer Laser Combined With Drug-coated Balloon for Instent Restenosis and the Relationship With Different Neointimal Tissues Defined by Optical Coherence Tomography
10.3969/j.issn.1000-3614.2024.02.005
- VernacularTitle:准分子激光冠状动脉成形术联合药物涂层球囊治疗支架内再狭窄的即刻管腔获益及与光学相干断层成像下不同内膜组织特征间的关系
- Author:
Pan HE
1
,
2
;
Junjie YANG
;
Haiwei CHEN
;
Anping DENG
;
Zhigeng JIN
;
Lei GAO
;
Jun GUO
;
Yundai CHEN
;
Qi WANG
Author Information
1. 中国人民解放军总医院第一医学中心 心血管内科,北京 100853
2. 中国人民解放军医学院,北京 100853
- Keywords:
in-stent restenosis;
excimer laser coronary angioplasty;
drug-coated balloon;
optical coherence tomography
- From:
Chinese Circulation Journal
2024;39(2):133-139
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To compare the efficacy of the combination of excimer laser coronary angioplasty(ELCA)and drug-coated balloon(DCB)for in-stent restenosis(ISR)and to evaluate the impact of neointimal tissue characteristics on treatment outcomes. Methods:A total of 96 ISR lesions from 86 patients who underwent optical coherence tomography(OCT)evaluation and DCB with or without ELCA treatment at The First Medical Center of Chinese PLA General Hospital from January 2019 to May 2023 were retrospectively analyzed.ISR lesions were divided into ELCA+DCB group(n=30)and DCB group(n=66).Additionally,ISR lesions were classified as homogeneous and non-heterogeneous patterns based on the OCT characteristics of the neointimal tissue,and the impact on acute lumen gains was compared between different ISR patterns.Acute lumen gain(ΔMLA)was defined as the changes in minimum lumen area before and after the intervention. Results:The ELCA+DCB group had a significantly greater ΔMLA than the DCB group([3.2±0.8]mm2 vs.[2.6±1.4]mm2,P=0.015).Among the ISR with a homogeneous pattern,the ΔMLA of the ELCA+DCB group was significantly greater than that of the DCB group([3.0±0.9]mm2 vs.[2.2±1.1]mm2,P=0.030).There was no significant difference in ΔMLA between the two ISR groups with the non-homogeneous pattern([3.4±0.7]mm2 vs.[3.2±1.5]mm2,P=0.533).There was no death,the rate of target lesion revascularization was similar between the patients with lesions receiving DCB treatment and patients receiving ELCA +DCB treatment(7.4%vs.4.2%,P＞0.05). Conclusions:The combination of ELCA and DCB is an effective strategy for treating ISR,which can achieve greater acute lumen gain compared to DCB treatment alone,especially for the treatment of homogenous ISR pattern characterized by OCT.
