Safety and Long-Term Efficacy of Drug-Coated Balloon Angioplasty following Rotational Atherectomy for Severely Calcified Coronary Lesions Compared with New Generation Drug-Eluting Stents
Joint Authors
Takahashi, Hiroshi
Ueno, Katsumi
Morita, Norihiko
Kojima, Yoshinobu
Kawasaki, Masanori
Ito, Ryuta
Kondo, Hiroki
Minatoguchi, Shingo
Yoshida, Tamami
Hashimoto, Yasumasa
Tatsumi, Tomohiko
Kitamura, Tomoya
Source
Journal of Interventional Cardiology
Issue
Vol. 2019, Issue 2019 (31 Dec. 2019), pp.1-10, 10 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2019-03-13
Country of Publication
Egypt
No. of Pages
10
Main Subjects
Abstract EN
Objectives.
This study sought to assess the safety and long-term efficacy of drug-coated balloons (DCB) following aggressive intracoronary image-guided rotational atherectomy (iRA) for severe coronary artery calcification (CAC), and to compare this strategy with new generation drug-eluting stents (nDES) following iRA.
Background.
Ischemic events following the treatment of CAC is still relatively high.
Thus, more innovative strategies are required.
Methods.
We evaluated 123 consecutive patients (166 lesions) with de novo CAC undergoing an iRA (burr size; 0.7 of the mean reference diameter by intracoronary imaging) followed by DCB (DCB-iRA; 54 patients, 68 lesions) or nDES (nDES-iRA; 69 patients, 98 lesions).
Follow-up angiography was obtained at > 6 months.
Results.
The target vessels (right coronary and circumflex), bifurcation (67.6% versus 47.9%), reference diameter (2.28mm versus 2.49mm), and lesion length (11.89mm versus 18.78mm) were significantly different between the two groups.
The median follow-up was 732 days.
TLR and TVR in DCB-iRA and nDES-iRA at 3 years were similar: 15.6% versus 16.3% (P=0.99) and 15.6% versus 23.3% (P=0.38).
In 41 well-matched lesion pairs after propensity score analysis, the cumulative incidence of TLR and TVR in DCB-iRA and nDES-iRA at 3 years was 12.9% versus 16.3% (P=0.70) and 12.9% versus 26.1% (P=0.17), respectively.
On QCA analysis, although the acute gain was smaller in DCB-iRA (0.85 mm versus 1.53 mm, P<0.001), the minimum lumen diameter at follow-up was similar (1.69 mm versus 1.87 mm, P=0.29).
The late lumen loss was lower (0.09 mm versus 0.52 mm, P=0.009) in DCB-iRA.
Conclusions.
DCB-iRA is feasible for CAC.
American Psychological Association (APA)
Ueno, Katsumi& Morita, Norihiko& Kojima, Yoshinobu& Takahashi, Hiroshi& Kawasaki, Masanori& Ito, Ryuta…[et al.]. 2019. Safety and Long-Term Efficacy of Drug-Coated Balloon Angioplasty following Rotational Atherectomy for Severely Calcified Coronary Lesions Compared with New Generation Drug-Eluting Stents. Journal of Interventional Cardiology،Vol. 2019, no. 2019, pp.1-10.
https://search.emarefa.net/detail/BIM-1181296
Modern Language Association (MLA)
Ueno, Katsumi…[et al.]. Safety and Long-Term Efficacy of Drug-Coated Balloon Angioplasty following Rotational Atherectomy for Severely Calcified Coronary Lesions Compared with New Generation Drug-Eluting Stents. Journal of Interventional Cardiology No. 2019 (2019), pp.1-10.
https://search.emarefa.net/detail/BIM-1181296
American Medical Association (AMA)
Ueno, Katsumi& Morita, Norihiko& Kojima, Yoshinobu& Takahashi, Hiroshi& Kawasaki, Masanori& Ito, Ryuta…[et al.]. Safety and Long-Term Efficacy of Drug-Coated Balloon Angioplasty following Rotational Atherectomy for Severely Calcified Coronary Lesions Compared with New Generation Drug-Eluting Stents. Journal of Interventional Cardiology. 2019. Vol. 2019, no. 2019, pp.1-10.
https://search.emarefa.net/detail/BIM-1181296
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1181296