Impact of Dissection after Drug-Coated Balloon Treatment of De Novo Coronary Lesions:Angiographic and Clinical Outcomes
10.3349/ymj.2020.61.12.1004
- Author:
Lin HUI
1
;
Eun-Seok SHIN
;
Eun Jung JUN
;
Youngjune BHAK
;
Scot GARG
;
Tae-Hyun KIM
;
Chang-Bae SOHN
;
Byung Joo CHOI
;
Liu KUN
;
Song Lin YUAN
;
Wang ZHI
;
Jiang HAO
;
Shi ZHENTAO
;
Tang QIANG
Author Information
1. Division of Cardiology, Department of Internal Medicine, Ulsan Medical Center, Ulsan, Korea
- Publication Type:Original Article
- From:Yonsei Medical Journal
2020;61(12):1004-1012
- CountryRepublic of Korea
- Language:English
-
Abstract:
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).
