Efficacy of drug‐coated balloon angioplasty after directional coronary atherectomy for coronary bifurcation lesions (DCA/DCB registry). Issue 5 (10th August 2020)

• Record Type: Journal Article
• Authors: Kitani, Shunsuke; Igarashi, Yasumi; Tsuchikane, Etsuo; Nakamura, Shigeru; Seino, Yoshitane; Habara, Maoto; Takeda, Yoshihiro; Shimoji, Kenichiro; Yasaka, Yoshinori; Kijima, Mikihiro
• Is Part Of: Catheterization and cardiovascular interventions. Volume 97:Issue 5(2021)
• Page Start: E614
• Page End: E623
• Publication Date: 2020-08-10
• Subjects: drug‐eluting stents -- intervention device -- percutaneous coronary intervention; Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.29185
• Languages: English
• ISSNs: 1522-1946

Abstract

Abstract: Objectives: To evaluate the efficacy and safety of additional drug‐coated balloon (DCB) angioplasty after directional coronary atherectomy (DCA) for coronary bifurcation lesions. Background: The optimal therapy for bifurcation lesions has not been established, even in the drug‐eluting stent era. DCA possibly prevents plaque and carina shift in bifurcation lesions by plaque debulking; however, the efficacy of combined DCA and DCB (DCA/DCB) for bifurcation lesions remains unclear. Methods: This multicenter registry retrospectively recruited patients with bifurcation lesions who underwent DCA/DCB and follow‐up angiogram at 6–15 months. The primary endpoint was the 12‐month target vessel failure (TVF) rate. The secondary endpoints were procedure‐related major complications, major cardiovascular events at 12 months, restenosis at 12 months, target lesion revascularization (TLR) at 12 months, and target vessel revascularization (TVR) at 12 months. Results: We enrolled 129 patients from 16 Japanese centers. One hundred and four lesions (80.6%) were located around the left main trunk bifurcations. No side branch compromise was found intraoperatively. Restenosis was observed in three patients (2.3%) at 12 months. TLR occurred in four patients (3.1%): 3 (2.3%) in the main vessel and 1 (0.8%) in the ostium of the side branch at 12 months. TVF incidence at 12 months was slightly higher in 14 patients (10.9%), and only two patients (1.6%) had symptomatic TVR. One patient (0.8%) had non‐target vessel‐related myocardial infarction. Conclusions: Our data suggested that DCA/DCB provided good clinical outcomes and minimal side branch damage and could be an optimal non‐stent percutaneous coronary intervention strategy for bifurcation lesions.