Mid-Term Clinical Outcomes Following Drug-Coated Balloons in Coronary Artery Disease.
Mid-Term Clinical Outcomes Following Drug-Coated Balloons in Coronary Artery Disease.
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DOI：
10.3390/jcm11071859
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发表时间：
2022-03-27
影响因子：
3.9
通讯作者：
Blatt, Alex
中科院分区：
文献类型：
--
作者：
Sella, Gal;Gandelman, Gera;Teodorovich, Nicholay;Tuvali, Ortal;Ayyad, Omar;Abu Khadija, Haitham;Haberman, Dan;Poles, Lion;Jonas, Michael;Volodarsky, Igor;George, Jacob;Blatt, Alex
目的：本研究旨在评价药物涂层球囊（DCB）在两种不同病理生理情况下经皮冠状动脉介入治疗（PCI）中的中期有效性。背景：冠心病有不同的病理基础。DCB方法的中期安全性和有效性仍然有限。方法：对所有接受DCB的连续患者的病历进行评价。主要终点是24个月后临床驱动的靶病变血运重建（TLR）率。结果：2011年1月至2017年12月期间，纳入了442例患者，占我们机构所有PCI的4.4%。共治疗了460处DCB病变，其中328处（71.3%）为原发病变，132处（28.7%）为裸金属或药物洗脱支架联合支架内再狭窄（ISR）。患者的平均年龄为66.2 ± 11.7岁，糖尿病患病率为45.3%。初治组的TLR率（5.3%）低于ISR组（9.4%）（p = 0.04）。初治组（38.9%）和ISR组（42.5%）的主要心血管不良事件（MACE）无差异（p = 0.47）。在亚组分析中未检测到TLR发生率的显著差异。结论：我们的长期经验表明，在这两种病理生理环境中，中期DCB方法是一种合理的选择，TLR率较低。
Objective: The aim of this study was to evaluate the mid-term efficacy of drug-coated balloons (DCB) in percutaneous coronary intervention (PCI) in two different pathophysiologic scenarios. Background: There are different underlying pathological processes in coronary artery disease. Mid-term safety and efficacy of DCB approach is still limited. Methods: Medical records of all consecutive patients undergoing DCB were evaluated. The primary endpoint was the rate of clinically driven target lesion revascularization (TLR) after 24 months. Results: Between January 2011 and December 2017, 442 patients were included, representing 4.4% of all PCIs in our institution. A total of 460 DCB lesions were treated, of which 328 (71.3%) were de novo and 132 (28.7%) were combined bare metal or drug-eluting stents with in-stent restenosis (ISR). The patients’ mean age was 66.2 ± 11.7 years with a diabetes prevalence of 45.3%. The TLR rate was lower in the de novo group (5.3%) compared to the ISR group (9.4%) (p = 0.04). No differences were observed in major adverse cardiovascular events (MACE) between the de novo group (38.9%) and ISR group (42.5%) (p = 0.47). No significant differences were detected in the TLR occurrence in the subgroup analysis. Conclusion: Our extended experience demonstrates that the mid-term DCB approach in these two pathophysiologic settings represent a reasonable option, with low TLR rate.
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