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药物涂层球囊-only 策略治疗左主干冠状动脉分叉病变:无支架策略。

The Drug Coated Balloon-Only Strategy for Treatment of de Novo Left Main Coronary Artery Bifurcation Lesion: Stentless Strategy.

机构信息

Department of Cardiology, 191599Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, China.

Department of Emergency, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China.

出版信息

Clin Appl Thromb Hemost. 2022 Jan-Dec;28:10760296221118489. doi: 10.1177/10760296221118489.

DOI:10.1177/10760296221118489
PMID:35945818
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9373168/
Abstract

The study aimed to evaluate the efficacy and safety of drug coated balloon-only strategy (DCB-only) in the treatment of de novo left main coronary artery (LM) bifurcation lesions. 85 patients were enrolled in this study and classified them into two groups: DCB-only group (n = 36) and DES group (n = 49). The MLD of target vessels was measured before and immediately after percutaneous coronary intervention (PCI) and late luminal loss (LLL) were also calculated. And the occurrence of major adverse cardiovascular events (MACE) was also evaluated. Compared with that before PCI, the MLD of target lesions significantly increased immediately after PCI ( < .05) and no MACE was recorded during the perioperative period both in two groups. The MLD at follow-up was significantly higher than that before both DCB and DES treatment. Compared with the DES group, the MLD of the DCB group was smaller than immediately after PCI in the LM and LAD ( < .05). The LLL of LAD in DCB group was smaller than that in DES group ( < .05). There was no significant difference in the incidence of luminal restenosis at the target lesion between the two groups, and no significant difference in the incidence of MACE ( > .05). The use of DCB-only to treat de novo LM bifurcation lesions is effective and relatively safe, which provides new ideas for the treatment of LM coronary artery bifurcation lesions in the future.

摘要

本研究旨在评估药物涂层球囊(DCB)治疗新出现的左主干冠状动脉(LM)分叉病变的疗效和安全性。共纳入 85 例患者,分为 DCB 组(n=36)和 DES 组(n=49)。在经皮冠状动脉介入治疗(PCI)前后测量目标血管的最小管腔直径(MLD),并计算晚期管腔丢失(LLL)。评估主要不良心血管事件(MACE)的发生情况。与 PCI 前相比,两组患者的目标病变 MLD 在 PCI 后即刻均显著增加( < .05),围手术期均无 MACE 发生。随访时 MLD 明显高于 DCB 和 DES 治疗前。与 DES 组相比,LM 和 LAD 段 DCB 组的 MLD 小于 PCI 即刻( < .05)。DCB 组的 LAD 段 LLL 小于 DES 组( < .05)。两组患者的靶病变管腔再狭窄发生率无显著差异,MACE 发生率亦无显著差异( > .05)。单纯使用 DCB 治疗新出现的 LM 分叉病变是有效且相对安全的,为未来治疗 LM 冠状动脉分叉病变提供了新思路。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5df/9373168/d41c1d397019/10.1177_10760296221118489-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5df/9373168/d41c1d397019/10.1177_10760296221118489-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5df/9373168/d41c1d397019/10.1177_10760296221118489-fig1.jpg

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2
Drug-coated balloon for treatment of de-novo coronary artery lesions in patients with high bleeding risk (DEBUT): a single-blind, randomised, non-inferiority trial.药物涂层球囊治疗高出血风险患者新发冠状动脉病变(DEBUT):一项单盲、随机、非劣效性试验。
Lancet. 2019 Jul 20;394(10194):230-239. doi: 10.1016/S0140-6736(19)31126-2. Epub 2019 Jun 13.
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Front Cardiovasc Med. 2024 Mar 20;11:1287852. doi: 10.3389/fcvm.2024.1287852. eCollection 2024.
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Safety and Efficacy of Drug-Coated Balloons in Patients with Acute Coronary Syndromes and Vulnerable Plaque.药物涂层球囊治疗急性冠状动脉综合征伴易损斑块患者的安全性和疗效。
Clin Appl Thromb Hemost. 2022 Jan-Dec;28:10760296221130063. doi: 10.1177/10760296221130063.
Paclitaxel-Coated Balloon Angioplasty Versus Drug-Eluting Stent in Acute Myocardial Infarction: The REVELATION Randomized Trial.
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