Sella Gal, Gandelman Gera, Teodorovich Nicholay, Tuvali Ortal, Ayyad Omar, Abu Khadija Haitham, Haberman Dan, Poles Lion, Jonas Michael, Volodarsky Igor, George Jacob, Blatt Alex
Heart Center, Kaplan Medical Center, Rehovot, Hebrew University, Jerusalem 91905, Israel.
J Clin Med. 2022 Mar 27;11(7):1859. doi: 10.3390/jcm11071859.
The aim of this study was to evaluate the mid-term efficacy of drug-coated balloons (DCB) in percutaneous coronary intervention (PCI) in two different pathophysiologic scenarios.
There are different underlying pathological processes in coronary artery disease. Mid-term safety and efficacy of DCB approach is still limited.
Medical records of all consecutive patients undergoing DCB were evaluated. The primary endpoint was the rate of clinically driven target lesion revascularization (TLR) after 24 months.
Between January 2011 and December 2017, 442 patients were included, representing 4.4% of all PCIs in our institution. A total of 460 DCB lesions were treated, of which 328 (71.3%) were de novo and 132 (28.7%) were combined bare metal or drug-eluting stents with in-stent restenosis (ISR). The patients' mean age was 66.2 ± 11.7 years with a diabetes prevalence of 45.3%. The TLR rate was lower in the de novo group (5.3%) compared to the ISR group (9.4%) ( = 0.04). No differences were observed in major adverse cardiovascular events (MACE) between the de novo group (38.9%) and ISR group (42.5%) ( = 0.47). No significant differences were detected in the TLR occurrence in the subgroup analysis.
Our extended experience demonstrates that the mid-term DCB approach in these two pathophysiologic settings represent a reasonable option, with low TLR rate.
本研究旨在评估药物涂层球囊（DCB）在两种不同病理生理情况下经皮冠状动脉介入治疗（PCI）的中期疗效。
冠状动脉疾病存在不同的潜在病理过程。DCB治疗方法的中期安全性和疗效仍然有限。
对所有接受DCB治疗的连续患者的病历进行评估。主要终点是24个月后临床驱动的靶病变血运重建（TLR）率。
2011年1月至2017年12月期间，纳入442例患者，占我院所有PCI患者的4.4%。共治疗460个DCB病变，其中328个（71.3%）为初发病变，132个（28.7%）为裸金属支架或药物洗脱支架合并支架内再狭窄（ISR）病变。患者的平均年龄为66.2±11.7岁，糖尿病患病率为45.3%。初发病变组的TLR率（5.3%）低于ISR组（9.4%）（P=0.04）。初发病变组（38.9%）和ISR组（42.5%）之间的主要不良心血管事件（MACE）无差异（P=0.47）。亚组分析中TLR发生率未检测到显著差异。
我们的扩展经验表明，在这两种病理生理情况下，中期DCB治疗方法是一种合理的选择，TLR率较低。
