Department of Cardiology, Matsunami General Hospital, Kasamatsu, Japan.
Department of Medical Statistics, Fujita Health University School of Medicine, Toyoake, Japan.
J Interv Cardiol. 2020 Dec 27;2020:6615988. doi: 10.1155/2020/6615988. eCollection 2020.
This study sought to assess the efficacy of oversized drug-coated balloon (DCB) inflation at low pressure for the prevention of acute dissections and late restenosis.
The major limitation of DCB coronary angioplasty is the occurrence of severe dissection after inflation of DCB.
Between 2014 and 2018, 273 consecutive patients were retrospectively studied. 191 lesions (154 patients) treated by oversized DCB inflation at low pressure (<4 atm, 2.4 ± 1.2 atm, DCB/artery ratio 1.14 ± 0.22; LP group) were compared with 135 lesions (119 patients) treated by the standard DCB technique (7.1 ± 2.2 atm, DCB/artery ratio 1.03 ± 0.16; SP group).
Although the lesions in the LP group were more complex than those in the SP group (smaller reference diameter (2.38 mm vs. 2.57 mm, =0.011), longer lesions (11.7 mm vs. 10.5 mm, =0.10), and more frequent use of rotational atherectomy (45.0% vs. 28.1%, =0.003), there was no significant difference in the NHLBI type of dissections between the two groups (11.5%, 12.0%, 5.2% vs. 12.6%, 12.6%, 2.2% in type , , and , =0.61), and no bailout stenting was required. In 125 well-matched lesion pairs after propensity score analysis, the cumulative incidence of target lesion revascularization at 3 years was 4.5% vs. 7.0%, respectively (=0.60). Late lumen loss (-0.00 mm vs. -0.01 mm, =0.94) and restenosis rates (7.4% vs. 7.1%, =1.0) were similar in both of the groups.
The application of oversized DCB at low pressure is effective and feasible for preventing late restenosis comparative to the standard technique of DCB.
本研究旨在评估低压大球囊扩张术（DCB）治疗预防急性夹层和晚期再狭窄的疗效。
DCB 冠状动脉成形术的主要局限性在于 DCB 扩张后发生严重夹层。
回顾性分析 2014 年至 2018 年间连续 273 例患者的临床资料。191 处病变（154 例患者）接受低压大球囊扩张术（<4atm，2.4±1.2atm，DCB/动脉比 1.14±0.22；LP 组），与 135 处病变（119 例患者）接受标准 DCB 技术（7.1±2.2atm，DCB/动脉比 1.03±0.16；SP 组）进行比较。
尽管 LP 组的病变比 SP 组更复杂（参考直径更小（2.38mm 比 2.57mm，=0.011），病变更长（11.7mm 比 10.5mm，=0.10），并且更频繁地使用旋磨术（45.0%比 28.1%，=0.003），但两组的 NHLBI 夹层类型无显著差异（11.5%、12.0%、5.2%比 12.6%、12.6%、2.2%在类型、和，=0.61），且无需紧急支架置入。经倾向评分分析后，在 125 对匹配良好的病变对中，3 年时的靶病变血运重建累积发生率分别为 4.5%和 7.0%（=0.60）。两组的晚期管腔丢失（-0.00mm 比-0.01mm，=0.94）和再狭窄率（7.4%比 7.1%，=1.0）相似。
与标准 DCB 技术相比，低压大球囊扩张术治疗可有效且可行，可预防晚期再狭窄。
