- 作者：Isao Taguchi ; Michiya Kageyama ; Tomoaki Kanaya ; Shichiro Abe ; Koichi Node ; Teruo Inoue
- 关键词：&lsquo ; Stentless&rsquo ; percutaneous coronary intervention ; Lacrosse® ; non-slip element balloon ; Drug-eluting stent ; Restenosis
- 刊名：Journal of Cardiology
- 出版年：January, 2014
- 年：2014
- 卷：63
- 期：1
- 页码：19-23
- 全文大小：432 K
Background
Recent advances in drug-eluting stent (DES) technology have succeeded in reducing restenosis. However, the use of DES is reportedly equivalent to bare metal stents in terms of long-term survival. In addition, stent materials represent foreign bodies, which if possible should not ideally be left within the patient. On these bases, an investigation was performed into the feasibility of a new approach, 鈥榮tentless鈥?percutaneous coronary intervention (PCI), using a Lacrosse庐 non-slip element (NSE) balloon (Goodman Co., Ltd., Nagoya, Japan).Methods and results
In our 鈥榮tentless鈥?approach, the NSE balloon is used for target lesion dilation in patients with low risk factors and simple target lesions. No stenting was performed once an optimal dilatation result was achieved, as evaluated by intravascular ultrasound (IVUS). In a total of 340 lesions in 304 patients, in whom the follow-up study was completed, the 鈥榮tentless鈥?PCI by NSE balloon alone was achieved in 52 lesions (15%). Target lesion revascularization (TLR) was performed for 5 (9.6%) of the 52 鈥榮tentless鈥?lesions. In the comparison between the 52 鈥榮tentless鈥?lesions and the 31 DES lesions selected under the statistical matching of the patient profiles and baseline lesion characteristics, the TLR rate (9.6% vs 6.5%, p = 0.616) and late lumen loss (0.52 卤 0.26 mm vs 0.48 卤 0.21 mm, p = 0.347) were similar. In the 52 鈥榮tentless鈥?lesions, IVUS parameters such as vessel area, minimal lumen area, and plaque area at both before and immediately after PCI were similar between the 5 TLR lesions and the 47 non TLR lesions.
Conclusions
It is believed that the 鈥榮tentless鈥?approach is applicable even in the DES era.