Drug-coated balloon-only strategy for percutaneous coronary intervention of <i>de novo</i> left main coronary artery disease: the importance of proper lesion preparation

doi:10.1007/s11684-022-0950-1

Front. Med.

2023, Vol. 17

Issue (1) : 75-84 https://doi.org/10.1007/s11684-022-0950-1

RESEARCH ARTICLE

Drug-coated balloon-only strategy for percutaneous coronary intervention of de novo left main coronary artery disease: the importance of proper lesion preparation

Sanna Uskela¹(

), Antti Eranti¹, Jussi M. Kärkkäinen², Tuomas T. Rissanen²

¹. North Karelia Central Hospital-Heart Center Tikkamaentie 16, Joensuu 80210, Finland
². Kuopio University Hospital Puijonlaaksontie 2, Kuopio, Pohjois-Savo 70210, Finland

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Abstract

This retrospective single-center registry study included all consecutive patients who underwent percutaneous coronary intervention (PCI) for a de novo left main coronary artery lesion using drug coated-balloon (DCB)-only strategy between August 2011 and December 2018. To best of our knowledge, no previous studies of DCB-only strategy of treating de novo left main coronary artery disease, exist. The primary endpoint was major adverse cardiovascular events (MACEs) including cardiac death, non-fatal myocardial infarction, and target lesion revascularization (TLR). The cohort was divided into two groups depending on weather the lesion preparation was done according to the international consensus group guidelines. Sixty-six patients (mean age 75±8.6, 72% male), 52% of whom had acute coronary syndrome, underwent left main PCI with the DCB-only strategy. No procedural mortality and no acute closures of the treated left main occurred. At 12 months, MACE and TLR occurred in 24% and 6% of the whole cohort, respectively. If the lesion preparation was done according to the guidelines, the MACE and TLR rates were 21.2% and 1.9%. Left main PCI with the DCB only-strategy is safe leading to acceptable MACE and low TLR rates at one year, if the lesion preparation is done according to the guidelines.

Keywords drug-coated balloon left main high bleeding risk predilatation calcifield lesion percutaneous coronary intervention

Corresponding Author(s): Sanna Uskela

Just Accepted Date: 08 November 2022 Online First Date: 25 December 2022 Issue Date: 15 March 2023

Cite this article:

Sanna Uskela,Antti Eranti,Jussi M. Kärkkäinen, et al. Drug-coated balloon-only strategy for percutaneous coronary intervention of de novo left main coronary artery disease: the importance of proper lesion preparation[J]. Front. Med., 2023, 17(1): 75-84.

URL:

https://academic.hep.com.cn/fmd/EN/10.1007/s11684-022-0950-1
https://academic.hep.com.cn/fmd/EN/Y2023/V17/I1/75

Fig.1 Patient flow in the study.

Tab.1 Patient characteristics and bleeding risk factors

Tab.2 Procedural characteristics

Tab.3 Procedural antithrombotics and anticoagulation

Tab.4 Duration of DAPT after PCI

Fig.2 Kaplan–Meier plots for survival free of MACE in all patients, and according to the predilatation result.

Tab.5 Adverse events (n (%)) among subjects with LM DCB PCI

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