Efficacy of Low-Pressure Inflation of Oversized Drug-Coated Balloon for Coronary Artery Disease

Objectives. This study sought to assess the efficacy of oversized drug-coated balloon (DCB) inflation at low pressure for the prevention of acute dissections and late restenosis. Background. The major limitation of DCB coronary angioplasty is the occurrence of severe dissection after inflation of DC...

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Main Authors: Katsumi Ueno, Norihiko Morita, Yoshinobu Kojima, Hiroki Kondo, Hiroshi Takahashi, Shingo Minatoguchi, Sho Higuchi, Yu Ando, Masayasu Esaki
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Journal of Interventional Cardiology
Online Access:http://dx.doi.org/10.1155/2020/6615988
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author Katsumi Ueno
Norihiko Morita
Yoshinobu Kojima
Hiroki Kondo
Hiroshi Takahashi
Shingo Minatoguchi
Sho Higuchi
Yu Ando
Masayasu Esaki
author_facet Katsumi Ueno
Norihiko Morita
Yoshinobu Kojima
Hiroki Kondo
Hiroshi Takahashi
Shingo Minatoguchi
Sho Higuchi
Yu Ando
Masayasu Esaki
author_sort Katsumi Ueno
collection DOAJ
description Objectives. This study sought to assess the efficacy of oversized drug-coated balloon (DCB) inflation at low pressure for the prevention of acute dissections and late restenosis. Background. The major limitation of DCB coronary angioplasty is the occurrence of severe dissection after inflation of DCB. Methods. Between 2014 and 2018, 273 consecutive patients were retrospectively studied. 191 lesions (154 patients) treated by oversized DCB inflation at low pressure (<4 atm, 2.4 ± 1.2 atm, DCB/artery ratio 1.14 ± 0.22; LP group) were compared with 135 lesions (119 patients) treated by the standard DCB technique (7.1 ± 2.2 atm, DCB/artery ratio 1.03 ± 0.16; SP group). Results. Although the lesions in the LP group were more complex than those in the SP group (smaller reference diameter (2.38 mm vs. 2.57 mm, P=0.011), longer lesions (11.7 mm vs. 10.5 mm, P=0.10), and more frequent use of rotational atherectomy (45.0% vs. 28.1%, P=0.003), there was no significant difference in the NHLBI type of dissections between the two groups (11.5%, 12.0%, 5.2% vs. 12.6%, 12.6%, 2.2% in type A, B, and C, P=0.61), and no bailout stenting was required. In 125 well-matched lesion pairs after propensity score analysis, the cumulative incidence of target lesion revascularization at 3 years was 4.5% vs. 7.0%, respectively (P=0.60). Late lumen loss (−0.00 mm vs. −0.01 mm, P=0.94) and restenosis rates (7.4% vs. 7.1%, P=1.0) were similar in both of the groups. Conclusion. The application of oversized DCB at low pressure is effective and feasible for preventing late restenosis comparative to the standard technique of DCB.
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spelling doaj-art-91835bfcf2e345bdb556b94491491f5c2025-08-20T02:09:55ZengWileyJournal of Interventional Cardiology0896-43271540-81832020-01-01202010.1155/2020/66159886615988Efficacy of Low-Pressure Inflation of Oversized Drug-Coated Balloon for Coronary Artery DiseaseKatsumi Ueno0Norihiko Morita1Yoshinobu Kojima2Hiroki Kondo3Hiroshi Takahashi4Shingo Minatoguchi5Sho Higuchi6Yu Ando7Masayasu Esaki8Department of Cardiology, Matsunami General Hospital, Kasamatsu, JapanDepartment of Cardiology, Matsunami General Hospital, Kasamatsu, JapanDepartment of Cardiology, Matsunami General Hospital, Kasamatsu, JapanDepartment of Cardiology, Matsunami General Hospital, Kasamatsu, JapanDepartment of Medical Statistics, Fujita Health University School of Medicine, Toyoake, JapanDepartment of Cardiology, Gifu University Graduate School of Medicine, Gifu, JapanDepartment of Cardiology, Matsunami General Hospital, Kasamatsu, JapanDepartment of Cardiology, Kizawa Memorial Hospital, Minokamo, JapanDepartment of Cardiology, Matsunami General Hospital, Kasamatsu, JapanObjectives. This study sought to assess the efficacy of oversized drug-coated balloon (DCB) inflation at low pressure for the prevention of acute dissections and late restenosis. Background. The major limitation of DCB coronary angioplasty is the occurrence of severe dissection after inflation of DCB. Methods. Between 2014 and 2018, 273 consecutive patients were retrospectively studied. 191 lesions (154 patients) treated by oversized DCB inflation at low pressure (<4 atm, 2.4 ± 1.2 atm, DCB/artery ratio 1.14 ± 0.22; LP group) were compared with 135 lesions (119 patients) treated by the standard DCB technique (7.1 ± 2.2 atm, DCB/artery ratio 1.03 ± 0.16; SP group). Results. Although the lesions in the LP group were more complex than those in the SP group (smaller reference diameter (2.38 mm vs. 2.57 mm, P=0.011), longer lesions (11.7 mm vs. 10.5 mm, P=0.10), and more frequent use of rotational atherectomy (45.0% vs. 28.1%, P=0.003), there was no significant difference in the NHLBI type of dissections between the two groups (11.5%, 12.0%, 5.2% vs. 12.6%, 12.6%, 2.2% in type A, B, and C, P=0.61), and no bailout stenting was required. In 125 well-matched lesion pairs after propensity score analysis, the cumulative incidence of target lesion revascularization at 3 years was 4.5% vs. 7.0%, respectively (P=0.60). Late lumen loss (−0.00 mm vs. −0.01 mm, P=0.94) and restenosis rates (7.4% vs. 7.1%, P=1.0) were similar in both of the groups. Conclusion. The application of oversized DCB at low pressure is effective and feasible for preventing late restenosis comparative to the standard technique of DCB.http://dx.doi.org/10.1155/2020/6615988
spellingShingle Katsumi Ueno
Norihiko Morita
Yoshinobu Kojima
Hiroki Kondo
Hiroshi Takahashi
Shingo Minatoguchi
Sho Higuchi
Yu Ando
Masayasu Esaki
Efficacy of Low-Pressure Inflation of Oversized Drug-Coated Balloon for Coronary Artery Disease
Journal of Interventional Cardiology
title Efficacy of Low-Pressure Inflation of Oversized Drug-Coated Balloon for Coronary Artery Disease
title_full Efficacy of Low-Pressure Inflation of Oversized Drug-Coated Balloon for Coronary Artery Disease
title_fullStr Efficacy of Low-Pressure Inflation of Oversized Drug-Coated Balloon for Coronary Artery Disease
title_full_unstemmed Efficacy of Low-Pressure Inflation of Oversized Drug-Coated Balloon for Coronary Artery Disease
title_short Efficacy of Low-Pressure Inflation of Oversized Drug-Coated Balloon for Coronary Artery Disease
title_sort efficacy of low pressure inflation of oversized drug coated balloon for coronary artery disease
url http://dx.doi.org/10.1155/2020/6615988
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