目的:在新冠状动脉分叉病变的情况下,药物涂层球囊(DCB)治疗后的侧支(SB)开口效应的数据有限。我们旨在研究DCB治疗后SB口的血管造影结果,与药物洗脱支架(DESs)植入主血管(MV)或最佳药物治疗(OMT)治疗新冠状动脉分叉病变相比。
方法:比较了DCB之间SB口的连续血管造影变化,DES,和单独药物治疗MV。通过从手术前值中减去随访值来计算Δ值。
结果:共纳入132个分叉病变进行分析(DCB组44个病变;DES组38个病变;OMT组50个病变)。DCB组随访时SB口最小管腔直径(MLD)增加,而在DES和OMT组均观察到下降(DCB组的ΔMLD:-0.16±0.45mm与0.50±0.52mm的DES组与OMT组0.08±0.38mm,p<0.001)。在DCB组的随访中,SB口的直径狭窄(DS)明显减少。与在DES和OMT组中观察到的增加相反(DCB组的ΔDS:8.01±18.96%DES组的-18.68±18.60%OMT组-2.05±14.58%,p<0.001)。
结论:在新冠状动脉分叉病变中,与DES植入或OMT相比,在6-9个月随访时,对MV的DCB治疗在SB口显示出良好的血管造影结果。
OBJECTIVE: Data on side-branch (SB) ostial effect after drug-coated balloon (DCB) treatment in the context of de novo coronary bifurcation lesions are limited. We aimed to investigate the angiographic outcomes of SB ostium after DCB treatment compared with drug-eluting stents (DESs) implantation in the main vessel (MV) or optimal medical therapy (OMT) for the treatment of de novo coronary bifurcation lesions.
METHODS: Serial angiographic changes in the SB ostium were compared between DCB, DES, and medication alone for MV treatment. Δ value was calculated by subtracting the follow-up value from the pre-procedure value.
RESULTS: A total of 132 bifurcation lesions were included for analysis (44 lesions in DCB group; 38 lesions in DES group; 50 lesions in OMT group). The minimal lumen diameter (MLD) of SB ostium showed an increase at follow-up in the DCB group, whereas a decrease was observed in both the DES and OMT groups (ΔMLD: -0.16 ± 0.45 mm for DCB group vs. 0.50 ± 0.52 mm for DES group vs. 0.08 ± 0.38 mm for OMT group, p < 0.001). The diameter stenosis (DS) of SB ostium showed a marked decrease at follow-up in the DCB group, in contrast to an increase observed in both the DES and OMT groups (ΔDS: 8.01 ± 18.96% for DCB group vs. -18.68 ± 18.60% for DES group vs. -2.05 ± 14.58% for OMT group, p < 0.001).
CONCLUSIONS: In de novo coronary bifurcation lesions, DCB treatment on the MV demonstrated favorable angiographic outcomes in the SB ostium at 6-9 month follow-up compared to DES implantation or OMT.