Shin Eun-Seok, Ann Soe Hee, Jang Mi Hee, Kim Bitna, Kim Tae-Hyun, Sohn Chang-Bae, Choi Byung Joo
Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Republic of Korea.
Department of Cardiology, Ulsan Medical Center, Ulsan 44686, Republic of Korea.
J Clin Med. 2023 Sep 28;12(19):6254. doi: 10.3390/jcm12196254.
The aim of this study was to evaluate the efficacy of scoring balloon angioplasty for drug-coated balloon (DCB) treatment in percutaneous coronary intervention.
The scoring balloon angioplasty may play a pivotal role in enhancing the outcomes of DCB treatment.
A total of 259 patients (278 lesions) with coronary artery disease successfully treated with DCB were retrospectively enrolled. The mean age of the patients was 62.2 ± 11.1 years, and the majority of patients were men (68.7%). The study's endpoint was defined as achieving an optimal angiographic result, which consisted of Thrombolysis in Myocardial Infarction (TIMI) flow grade 3, residual diameter stenosis ≤ 30%, and dissection less than type C after the procedure.
Angioplasty was performed for 61 lesions with a scoring balloon and 217 lesions with a non-scoring balloon. All lesions were TIMI flow grade 3 except two lesions in the non-scoring balloon group. The scoring balloon group had a higher prevalence of residual diameter stenosis ≤ 30% (68.9% vs. 39.6%, < 0.001), while severe dissection, defined as type C or greater, was observed less frequently (9.8% vs. 31.8%, = 0.001). Moreover, the scoring balloon group achieved a superior rate of optimal angiographic results (60.7% vs. 28.6%, < 0.001). In multivariable analysis, scoring balloon (OR: 3.08 [95% confidence interval, 1.47-6.58], = 0.003) and DCB balloon-to-artery ratios (OR: 5.46 [95% confidence interval, 1.43-21.93], = 0.014) were independent factors in the increasing rate of optimal angiographic result.
The application of a scoring balloon catheter for lesion preparation, aiming to make them suitable for DCB treatment, was associated with a decreased risk of severe dissection and a greater occurrence of optimal angiographic outcomes compared with non-scoring balloon angioplasty.
本研究旨在评估在经皮冠状动脉介入治疗中，刻痕球囊血管成形术用于药物涂层球囊（DCB）治疗的疗效。
刻痕球囊血管成形术可能在提高DCB治疗效果方面发挥关键作用。
回顾性纳入259例（278处病变）成功接受DCB治疗的冠心病患者。患者的平均年龄为62.2±11.1岁，大多数患者为男性（68.7%）。该研究的终点定义为达到最佳血管造影结果，即心肌梗死溶栓（TIMI）血流3级、残余直径狭窄≤30%且术后夹层小于C型。
对61处病变使用刻痕球囊进行血管成形术，对217处病变使用非刻痕球囊进行血管成形术。除非刻痕球囊组的两处病变外，所有病变的TIMI血流均为3级。刻痕球囊组残余直径狭窄≤30%的发生率更高（68.9%对39.6%，P<0.001），而定义为C型或更严重的严重夹层的发生率较低（9.8%对31.8%，P = 0.001）。此外，刻痕球囊组达到最佳血管造影结果的比例更高（60.7%对28.6%，P<0.001）。在多变量分析中，刻痕球囊（比值比：3.08[95%置信区间，1.47 - 6.58]，P = 0.003）和DCB球囊与动脉比值（比值比：5.46[95%置信区间，1.43 - 21.93]，P = 0.014）是最佳血管造影结果增加率的独立因素。
与非刻痕球囊血管成形术相比，应用刻痕球囊导管进行病变预处理以使其适合DCB治疗，与严重夹层风险降低及更佳的血管造影结果发生率相关。
