AUTHOR=Hu Feng-Wang , Chang Shang , Li Qian , Zhu Yong-Xiang , Wang Xin-Yu , Cheng You-Wei , Zhou Qi-Hua , Liu Bing , Iqbal Javaid , Tang Xiao-Xia , Zhang Yao-Jun 

TITLE=Long-Term Clinical Outcomes After Percutaneous Coronary Intervention With Drug-Coated Balloon-Only Strategy in de novo Lesions of Large Coronary Arteries

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.882303

DOI=10.3389/fcvm.2022.882303

ISSN=2297-055X

ABSTRACT=Background and Objectives: Use of drug coated balloon (DCB)-only strategy for revascularization of native large coronary artery lesions is on the rise. The long-term efficacy of this approach for bifurcation and non-bifurcation lesions remains unknown. We aim to assess the long-term clinical outcomes of DCB-only strategy for the treatment of de novo bifurcation and non-bifurcation lesions in large coronary arteries.
Methods: This multicenter, prospective, observational study, enrolled 119 patients with de novo coronary lesions in vessels ≥2.75 mm. The primary endpoint was the rate of clinically driven target lesion failure (TLF), a composite of cardiac death, target vessel myocardial infarction, and clinically driven target lesion revascularization (TLR). Patients were followed up for a median of 2 years.
Results: Of 119 patients with 138 lesions, 66 patients (75 lesions) had bifurcation and 53 patients (63 lesions) had non-bifurcation lesions. Average reference vessel diameter of 3.1±0.3 mm and there was no difference in bifurcation and non-bifurcation group (3.0±0.3 vs. 3.1±0.3mm; p=0.27). At 2-year follow-up, the TLF occurred in 5 (4.2%), TLR in 4 (3.4%) and target vessel revascularization (TVR) in 5 (4.2%) cases. The frequency of TLR and TVR was higher in non-bifurcation group (p=0.04 and p=0.02, respectively), but there were no differences in TLF between two groups (p=0.17). The cumulative incidence of TLF (Kaplan-Meier estimates) was also not different in the two groups (Log Rank p=0.11).
Conclusions: DCB-only strategy for de novo lesions in large coronary arteries appears to be safe and effective for both bifurcation and non-bifurcation lesions. Further randomized clinical trials are warranted to confirm the value of DCB-only strategy in de novo bifurcation lesions of large vessels.