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Drug Coated Balloon-Only Strategy in De Novo Lesions of Large Coronary Vessels

狼牙棒 医学 冠状动脉疾病 传统PCI 心脏病学 冠状动脉 内科学 支架 血管成形术 气球 罪魁祸首 动脉 临床终点 血运重建 经皮冠状动脉介入治疗 药物洗脱支架 靶病变 人口 病变 再狭窄 外科 心肌梗塞 临床试验 环境卫生
作者
Mark Rosenberg,Matthias Waliszewski,Florian Krackhardt,Ken Min Chin,Wan Azman Wan Ahmad,Giuseppe Caramanno,Diego Milazzo,Amin Ariff Nuruddin,Houng Bang Liew,Oteh Maskon,A Bento,Jean Christophe Macia,Norbert Frey
出处
期刊:Journal of Interventional Cardiology [Hindawi Limited]
卷期号:2019: 1-8 被引量:24
标识
DOI:10.1155/2019/6548696
摘要

Objectives . We analyzed the efficacy of drug coated balloons (DCB) as a stand-alone-therapy in de novo lesions of large coronary arteries. DCBs seem to be an attractive alternative for the stent-free interventional treatment of de novo coronary artery disease (CAD). However, data regarding a DCB-only approach in de novo CAD are currently limited to vessels of small caliber. Methods . By means of propensity score (PS) matching 234 individuals with de novo CAD were identified with similar demographic characteristics. This patient population was stratified in a 1:1 fashion according to a reference vessel diameter cut-off of 2.75 mm in small and large vessel disease. The primary endpoint was the rate of clinically driven target lesion revascularization (TLR) at 9 months. Results . Patients with small vessel disease had an average reference diameter of 2.45 ± 0.23 mm, while the large vessel group averaged 3.16 ± 0.27 mm. Regarding 9-month major adverse cardiac event (MACE), 5.7% of the patients with small and 6.1% of the patients with large vessels had MACE (p=0.903). Analysis of the individual MACE components revealed a TLR rate of 3.8% in small and 1.0% in large vessels (p=0.200). Of note, no thrombotic events in the DCB treated coronary segments occurred in either group during the 9-month follow-up. Conclusions . Our data demonstrate for the first time that DCB-only PCI of de novo lesions in large coronary arteries (>2.75 mm) is safe and as effective. Interventional treatment for CAD without permanent or temporary scaffolding, demonstrated a similar efficacy for large and small vessels.

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