Abstract
The mechanism of how angiographic results following paclitaxel-coated balloon (PCB) treatment for small vessel disease affect patient outcome remains unknown. In the present study, we aimed to investigate the correlation between coronary dissection immediately after PCB angioplasty and midterm outcome. From March 2014 to March 2017, 171 consecutive patients with 228 native coronary artery lesions who received PCB angioplasty at a single center were enrolled retrospectively. Lesions with a reference vessel diameter > 2.8 mm were excluded. There were dissections in 80% of the lesions immediately following PCB angioplasty. Of these, 38% were type A, 29% were type B, and 13% were type C or more severe dissection. No patient required revascularization during hospitalization. We were able to follow 159 patients (212 lesions) clinically for > 6 months, from among whom target lesion revascularization (TLR) was performed in 7% of the patients. Follow-up angiography was performed on 143 lesions (67%), and complete healing of all dissections was noted. The rates of restenosis and late lumen enlargement were 12% and 56%, respectively. Multivariate analysis identified that a bending lesion was an independent predictor of TLR, and type C–E dissection and imaging device use were independent predictors of restenosis. Conversely, lesions with type B dissection had a larger net gain than lesions with type A or no dissection. Leaving the dissection uncovered after PCB angioplasty seems to be safe, resulting in a low acute event rate. The type B dissection after PCB angioplasty was the most therapeutic dissection.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required. The study protocol was reviewed and approved by the institutional review boards and ethics committee of our hospital.
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Funatsu, A., Kobayashi, T., Mizobuchi, M. et al. Clinical and angiographic outcomes of coronary dissection after paclitaxel-coated balloon angioplasty for small vessel coronary artery disease. Cardiovasc Interv and Ther 34, 317–324 (2019). https://doi.org/10.1007/s12928-019-00571-3
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DOI: https://doi.org/10.1007/s12928-019-00571-3