AUTHOR=Hu Feng-Wang , Chang Shang , Li Qian , Zhu Yong-Xiang , Wang Xin-Yu , Cheng You-Wei , Zhou Qi-Hua , Liu Bing , Iqbal Javaid , Tang Xiao-Xia , Zhang Yao-Jun 

TITLE=Long-Term Clinical Outcomes After Percutaneous Coronary Intervention With Drug-Coated Balloon-Only Strategy in de novo Lesions of Large Coronary Arteries

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.882303

DOI=10.3389/fcvm.2022.882303

ISSN=2297-055X

ABSTRACT=<sec><title>Background and Objectives</title><p>Use of drug-coated balloon (DCB)-only strategy for revascularization of native large coronary artery lesions is on the rise. The long-term efficacy of this approach for bifurcation and non-bifurcation lesions remains unknown. We aim to assess the long-term clinical outcomes of DCB-only strategy for the treatment of <italic>de novo</italic> bifurcation and non-bifurcation lesions in large coronary arteries.</p></sec><sec><title>Methods</title><p>This multicenter, prospective, observational study enrolled 119 patients with <italic>de novo</italic> coronary lesions in vessels ≥2.75 mm. The primary end point was the rate of clinically driven target lesion failure (TLF), a composite of cardiac death, target vessel myocardial infarction, and clinically driven target lesion revascularization (TLR). Patients were followed up for a median of 2 years.</p></sec><sec><title>Results</title><p>Of 119 patients with 138 lesions, 66 patients (75 lesions) had bifurcation and 53 patients (63 lesions) had non-bifurcation lesions. Average reference vessel diameter was 3.1 ± 0.3 mm, and there was no difference in bifurcation and non-bifurcation group (3.0 ± 0.3 vs. 3.1 ± 0.3mm; <italic>p</italic> = 0.27). At 2-year follow-up, the TLF occurred in five (4.2%), TLR in four (3.4%), and target vessel revascularization (TVR) in five (4.2%) cases. The frequency of TLR and TVR was higher in the non-bifurcation group (<italic>p</italic> = 0.04 and 0.02, respectively), but there were no differences in TLF between the two groups (<italic>p</italic> = 0.17). The cumulative incidence of TLF (Kaplan–Meier estimates) was also not different in the two groups (log-rank <italic>p</italic> = 0.11).</p></sec><sec><title>Conclusion</title><p>DCB-only strategy for <italic>de novo</italic> lesions in large coronary arteries appears to be safe and effective for both bifurcation and non-bifurcation lesions. Further randomized clinical trials are warranted to confirm the value of DCB-only strategy in <italic>de novo</italic> bifurcation lesions of large vessels.</p></sec>