Shin Eun-Seok, Ann Soe Hee, Balbir Singh Gillian, Lim Kyung Hun, Kleber Franz X, Koo Bon-Kwon
Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.
Cardio Centrum Berlin, Academic Teaching Institution, Charité Universitätsmedizin Berlin, Berlin, Germany.
Catheter Cardiovasc Interv. 2016 Aug;88(2):193-200. doi: 10.1002/ccd.26257. Epub 2015 Oct 1.
To assess the safety and efficacy of fractional flow reserve (FFR) guided paclitaxel-coated balloon (PCB) treatment for de novo coronary artery lesions.
There is limited data on PCB treatment for de novo lesions especially of major epicardial coronary arteries.
Sixty-six patients with 67 de novo lesions who underwent successful plain old balloon angioplasty (POBA) were included. If POBA-FFR was favorable (≥ 0.85), PCB was applied and if POBA-FFR was <0.85, stent implantation was preferred over PCB.
Forty-five lesions were treated with PCB (67.2%) and 22 lesions with stents (32.8%). Dual antiplatelet therapy duration was 6 weeks. Late luminal loss with PCB was significantly less than stent (0.05 ± 0.27 mm vs. 0.40 ± 0.54 mm, P = 0.022). The baseline FFR of target lesions was 0.69 ± 0.16 in PCB and 0.60 ± 0.11 in stent group (P = 0.015), however, the FFR at 9 months was not different between groups (0.85 ± 0.08 in PCB vs. 0.85 ± 0.05 in stent group, P = 0.973). At 1 year, one myocardial infarction and one target lesion revascularization related to in-stent restenosis were detected, both in the stent group.
POBA-FFR-guided PCB treatment is safe and effective for de novo coronary lesions with good anatomical and physiological patency at mid-term follow-up. © 2015 Wiley Periodicals, Inc.
评估血流储备分数（FFR）指导下的紫杉醇涂层球囊（PCB）治疗初发冠状动脉病变的安全性和有效性。
关于PCB治疗初发病变，尤其是主要心外膜冠状动脉病变的数据有限。
纳入66例患有67处初发病变且成功接受普通球囊血管成形术（POBA）的患者。如果POBA-FFR良好（≥0.85），则应用PCB；如果POBA-FFR＜0.85，则优先于PCB进行支架植入。
45处病变接受了PCB治疗（67.2%），22处病变接受了支架治疗（32.8%）。双联抗血小板治疗持续时间为6周。PCB组的晚期管腔丢失显著低于支架组（0.05±0.27mm对0.40±0.54mm，P=0.022）。靶病变的基线FFR在PCB组为0.69±0.16，在支架组为0.60±0.11（P=0.015），然而，两组在9个月时的FFR无差异（PCB组为0.85±0.08，支架组为0.85±0.05，P=0.973）。在1年时，支架组检测到1例与支架内再狭窄相关的心肌梗死和1例靶病变血运重建。
POBA-FFR指导下的PCB治疗对初发冠状动脉病变是安全有效的，在中期随访时具有良好的解剖和生理通畅性。©2015威利期刊公司。
