Impact of Angiographic Result After Predilatation on Outcome After Drug-Coated Balloon Treatment of In-Stent Coronary Restenosis

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• 作者：Akihito Tanaka ; MD^a ; ^b ; Azeem Latib ; MD^a ; ^b ; Richard J. Jabbour ; MD^a ; ^b ; ^c ; Hiroyoshi Kawamoto ; MD^a ; ^b ; Francesco Giannini ; MD^b ; Marco Ancona ; MD^b ; Damiano Regazzoli ; MD^b ; Antonio Mangieri ; MD^b ; Roberto Mattioli ; MD^d ; Alaide Chieffo ; MD^b ; Mauro Carlino ; MD^b ; Matteo Montorfano ; MD^b ; Antonio Colombo ; MD^a ; ^b ; ^{info@emocolumbus.it" class="auth_mail" title="E-mail the corresponding author}
• 刊名：The American Journal of Cardiology
• 出版年：2016
• 出版时间：15 November 2016
• 年：2016
• 卷：118
• 期：10
• 页码：1460-1465
• 全文大小：581 K

文摘

This study investigates clinical outcomes after drug-coated balloon (DCB) treatment for in-stent restenosis (ISR) based on the angiographic result achieved after predilatation and before DCB treatment. Among ISR lesions treated with DCBs, 166 lesions with angiography immediately after predilatation were analyzed. The lesions were divided into 2 groups according to angiographic results after predilatation: (1) “adequate” defined as the presence of Thrombolysis In Myocardial Infarction 3 flow, residual stenosis ≤30%, and no major dissections (n = 98 lesions) or (2) “inadequate” (n = 68 lesions). The reference vessel diameters were larger (2.88 ± 0.39 vs 2.64 ± 0.52 mm, p = 0.001) and lesion lengths shorter in the adequate group (15.4 ± 11.2 vs 19.7 ± 13.9 mm, p = 0.04). During a median follow-up of 808 days, the cumulative target lesion revascularization (TLR) rate was lower in the adequate group (20.3% vs 35.5% at 2 years; p = 0.04). Multivariate analysis indicated that an angiographically inadequate result before DCB treatment was an independent predictor of TLR, even after adjusting for reference vessel diameter and lesion length (hazard ratio 1.99, 95% confidence interval 1.02 to 3.87, p = 0.04). In conclusion, angiographic results after lesion preparation appear to be a good predictor of TLR after DCB treatment for ISR.