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Lasers in Medical Science

, Volume 35, Issue 2, pp 403–412 | Cite as

The effect of the debulking by excimer laser coronary angioplasty on long-term outcome compared with drug-coating balloon: insights from optical frequency domain imaging analysis

  • Takao SatoEmail author
  • Keiichi Tsuchida
  • Sho Yuasa
  • Yuji Taya
  • Tomoyasu Koshikawa
  • Komei Tanaka
  • Satoshi Fujita
  • Yoshio Ikeda
  • Minoru Takahashi
  • Masaaki Okabe
  • Hirotaka Oda
  • Yoshifusa Aizawa
Original Article

Abstract

This study evaluated the 1-year efficacy of excimer laser coronary angioplasty (ELCA) before drug-coated balloon (DCB) dilatation for the treatment of in-stent restenosis (ISR). Forty consecutive patients with ISR were treated by DCB with or without the use of ELCA (ELCA plus DCB, N = 20; DCB alone, N = 20). Debulking efficiency (DE) value was defined as the neointima area on optical frequency domain imaging (OFDI) debulked by ELCA. The patients in the ELCA plus DCB group were divided into two groups (greater DE (GDE), N = 10; smaller DE (SDE), N = 10) based on the median value of DE. Thereafter, the ISR segment was prepared with a scoring balloon, followed by DCB. At follow-up, binary restenosis and target lesion revascularization (TLR) were evaluated. There were no significant differences in baseline characteristics such as age, comorbidity, and ISR type. Overall, the incidence of neoatherosclerosis in the ISR segment was 17.5%. Post-PCI, acute gain of minimum lumen diameter on quantitative coronary angiography and of minimum lumen area on OFDI was numerically higher in the GDE than in the SDE and the DCB alone group. At follow-up, the occurrences of binary restenosis and TLR in the ELCA plus DCB group were 20.0% and 10.0%; these values in the DCB alone group were 20.0% and 20.0%, respectively. Two patients from the SDE and none from the GDE developed TLR. DCB alone treatment was inferior to ELCA plus DCB treatment. However, greater ELCA debulking might be required to obtain optimal outcomes.

Keywords

Excimer laser coronary angioplasty In-stent restenosis Optical frequency domain imaging Drug-coating balloon 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Research involving human participants and/or animals

This research involves human participants.

Ethics approval and consent to participate

Written informed consent was obtained from all patients before enrollment. This study was carried out in conformance with the Declaration of Helsinki and the study protocol was approved by the ethics committee of Tachikawa General Hospital.

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Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2019

Authors and Affiliations

  • Takao Sato
    • 1
    Email author
  • Keiichi Tsuchida
    • 2
  • Sho Yuasa
    • 1
  • Yuji Taya
    • 1
  • Tomoyasu Koshikawa
    • 1
  • Komei Tanaka
    • 2
  • Satoshi Fujita
    • 1
  • Yoshio Ikeda
    • 1
  • Minoru Takahashi
    • 1
  • Masaaki Okabe
    • 1
  • Hirotaka Oda
    • 2
  • Yoshifusa Aizawa
    • 1
  1. 1.CardiologyTachikawa General HospitalNagaoka CityJapan
  2. 2.Niigata Municipal HospitalNiigataJapan

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