Goto Jun, Niizeki Takeshi, Iwayama Tadateru, Sasaki Toshiki, Watanabe Masafumi
Department of Cardiology, Okitama Public General Hospital, Yamagata, JPN.
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, JPN.
Cureus. 2024 Mar 17;16(3):e56346. doi: 10.7759/cureus.56346. eCollection 2024 Mar.
Drug-eluting stents (DES) are the major treatment option in percutaneous coronary intervention (PCI). Recently, drug-coated balloon (DCB) utilization has been increasing globally, leading to the expected new strategy of "stent-less PCI." This study aimed to evaluate the one-year outcome of DCB compared to DES.
Patients who underwent initial PCI for de novo lesions in our institution from January 2018 to December 2021 (n=337) were subjected to retrospective analysis. Among them, 75 patients were treated with DCB, while 262 patients were treated with DES. Target lesion failure (TLF) was evaluated during the follow-up period.
The proportion of PCIs for ACS was significantly lower in the DCB group (DCB, n=23, 30.7% vs. DES, n=143, 54.6%; p=0.001). The median device diameter and length in the DES group were larger than those in the DCB group (DCB, 2.60 mm vs. DES, 2.98 mm; p<0.001; DCB, 19.1 mm vs. DES, 25.2 mm; p<0.001). There was no significant difference between the DCB and DES groups in lesion calcification. The proportion of ostial lesions was significantly higher in the DCB group (DCB, n=13, 17.3% vs. DES, n=21, 8.0%; p=0.018). The cumulative rate of TLF (DCB, n=5, 6.7% vs. DES, n=18, 6.9%; p=0.951) did not significantly differ between the DCB and DES groups.
DCB may be as effective a strategy as DES in the patient who underwent initial PCI for a de novo lesion.
药物洗脱支架（DES）是经皮冠状动脉介入治疗（PCI）的主要治疗选择。近年来，药物涂层球囊（DCB）的全球使用量不断增加，催生了“无支架PCI”这一预期的新策略。本研究旨在评估DCB与DES相比的一年期疗效。
对2018年1月至2021年12月在我院因初发病变接受首次PCI的患者（n = 337）进行回顾性分析。其中，75例患者接受DCB治疗，262例患者接受DES治疗。在随访期间评估靶病变失败（TLF）情况。
DCB组中因急性冠状动脉综合征（ACS）接受PCI的比例显著低于DES组（DCB组，n = 23，30.7%；DES组，n = 143，54.6%；p = 0.001）。DES组的器械直径和长度中位数大于DCB组（DCB组，2.60 mm；DES组，2.98 mm；p < 0.001；DCB组，19.1 mm；DES组，25.2 mm；p < 0.001）。DCB组和DES组在病变钙化方面无显著差异。DCB组开口病变的比例显著高于DES组（DCB组，n = 13，17.3%；DES组，n = 21，8.0%；p = 0.018）。DCB组和DES组的TLF累积发生率无显著差异（DCB组，n = 5，6.7%；DES组，n = 18，6.9%；p = 0.951）。
对于因初发病变接受首次PCI的患者，DCB可能是与DES同样有效的策略。
