The Role of Drug-Eluting Balloons Alone or in Combination With Drug-Eluting Stents in the Treatment of De Novo Diffuse Coronary Disease

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• 作者：Charis Costopoulos ; Azeem Latib ; Toru Naganuma ; Aless ; ro Sticchi ; Filippo Figini ; S ; eep Basavarajaiah ; Mauro Carlino ; Alaide Chieffo ; Matteo Montorfano ; Charbel Naim ; Masanori Kawaguchi ; Francesco Giannini ; Antonio Colombo
• 关键词：diffuse coronary artery disease ; drug-eluting balloon(s) ; drug-eluting stent(s) ; target lesion revascularization
• 刊名：JACC: Cardiovascular Interventions
• 出版年：November, 2013
• 年：2013
• 卷：6
• 期：11
• 页码：1153-1159
• 全文大小：239 K

文摘

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Objectives

This study sought to investigate the role of drug-eluting balloons (DEB) alone or in combination with drug-eluting stents (DES) in the treatment of diffuse de novo coronary artery disease (CAD) (>25 mm).

Background

The use of DEB in diffuse CAD, either alone or in combination with DES, offers an alternative to stenting alone. Data regarding DEB in this context are limited.

Methods

We retrospectively evaluated all patients treated with DEB for diffuse CAD between June 2009 and October 2012. Endpoints analyzed were major adverse cardiac events, defined as all-cause death, myocardial infarction, and target vessel revascularization (TVR), as well as TVR and target lesion revascularization separately. Results were compared with those obtained from a cohort of patients with similar characteristics treated with DES alone.

Results

A total of 69 patients (93 lesions) were treated with DEB 卤 DES, and 93 patients with DES alone (93 lesions). A high proportion of patients were diabetic (46.4% vs. 44.1%, p聽= 0.77). Of the DEB-treated lesions, 56.0% were treated with DEB alone, 7.4% with DEB and DES as bail out, and 36.6% with DES and DEB as part of a hybrid approach for very long disease. Outcome rates with DEB 卤 DES were comparable to those with DES alone at 2-year follow-up (major adverse cardiac events聽= 20.8% vs. 22.7%, p聽= 0.74; TVR聽= 14.8% vs. 11.5%, p聽= 0.44; target lesion revascularization聽= 9.6% vs. 9.3%, p聽= 0.84).

Conclusions

DEB may have a role in the treatment of diffuse de novo CAD, either alone in smaller vessels or in combination with DES in very long disease.