Li Xiaotao, Yang Yuhong, Zhang Ran, Yang Dawei, Chen Xiaojie, Wang Jia, Zhang Chenhao
Department of Emergency.
Department of Acupuncture and Encephalopathy, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China.
Coron Artery Dis. 2025 Nov 1;36(7):587-594. doi: 10.1097/MCA.0000000000001543. Epub 2025 Jun 18.
The aim of this study was to explore the safety and efficacy of drug-eluting stents (DES) combined with drug-coated balloons (DCB) in the treatment of complex coronary artery lesions.
In total, 305 patients with complex coronary artery lesions who underwent percutaneous coronary intervention were retrospectively included in this study. The patients were divided into the DES combined with the DCB treatment group (hybrid group) and the DES-only treatment group (DES group), and the target lesion revascularization (TLR) and major adverse cardiovascular events (MACE) were compared between the two groups during 2-year follow-up.
There were no significant differences between the two groups in baseline clinical characteristics ( P > 0.05). In the treated lesions of reference vessel diameters (RVD) ≥3 mm, there were no significant differences in coronary angiography and interventional characteristics between the two groups. In the treated lesion of RVD <3mm, the hybrid group had a higher proportion of lesion preparation ( P <0.001) and a higher rate of residual stenosis ( P <0.001) than the DES group. During the 2-year follow-up, the clinical outcomes between the two groups showed no significant differences. After propensity score matching, there were still no significant differences between the two groups in the cumulative survival rates without TLR (95.8% vs. 94.2%; log-rank P = 0.560) or MACE (89.4% vs. 87.8%; log-rank P = 0.578) at 2-year follow-up.
During the 2-year follow-up, DES combined with DCB treatment showed similar efficacy and safety compared with DES-only treatment in complex coronary artery lesions.
本研究旨在探讨药物洗脱支架（DES）联合药物涂层球囊（DCB）治疗复杂冠状动脉病变的安全性和有效性。
本研究回顾性纳入了305例行经皮冠状动脉介入治疗的复杂冠状动脉病变患者。将患者分为DES联合DCB治疗组（混合组）和单纯DES治疗组（DES组），比较两组在2年随访期间的靶病变血运重建（TLR）和主要不良心血管事件（MACE）。
两组基线临床特征无显著差异（P＞0.05）。在参照血管直径（RVD）≥3 mm的治疗病变中，两组冠状动脉造影和介入特征无显著差异。在RVD＜3 mm的治疗病变中，混合组的病变预处理比例高于DES组（P＜0.001），残余狭窄率也高于DES组（P＜0.001）。在2年随访期间，两组临床结局无显著差异。倾向评分匹配后，两组在2年随访时无TLR的累积生存率（95.8%对94.2%；对数秩P = 0.560）或MACE发生率（89.4%对87.8%；对数秩P = 0.578）仍无显著差异。
在2年随访期间，DES联合DCB治疗与单纯DES治疗在复杂冠状动脉病变中的疗效和安全性相似。
