Abstract

JACC

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TCTAP A-042

Comparison Between Drug-Coated Balloon and Drug-Eluting Stent in Very Small Coronary Artery Intervention

By Cheng-Hsuan Tsai, Mao-Shin Lin, Ching-Chang Huang, Chih-Fan Yeh, Ying-Hsien Chen, Hsien-Li Kao

Presenter

Cheng-Hsuan Tsai

Authors

Cheng-Hsuan Tsai1, Mao-Shin Lin1, Ching-Chang Huang1, Chih-Fan Yeh1, Ying-Hsien Chen1, Hsien-Li Kao1

Affiliation

National Taiwan University Hospital, Taiwan1
View Study Report
TCTAP A-042
Drug-Eluting Balloons

Comparison Between Drug-Coated Balloon and Drug-Eluting Stent in Very Small Coronary Artery Intervention

Cheng-Hsuan Tsai1, Mao-Shin Lin1, Ching-Chang Huang1, Chih-Fan Yeh1, Ying-Hsien Chen1, Hsien-Li Kao1

National Taiwan University Hospital, Taiwan1

Background

Optimal management of very small vessel (reference diameters from 2.0 to 2.25 mm) in percutaneous coronary interventions (PCI) remained controversial. In this study, we aimed to compare the efficacy and safety of drug-coated balloons (DCB) and drug-eluting stent (DES) for de-novo very small vessel intervention. 

Methods

We conducted a retrospective analysis in consecutive patients who received very small vessel PCI with DCB or DES between Jan 2018 to March 2021. The outcome measures were the incidence of ischemia-driven target lesion revascularization (TLR) and the major adverse cardiac and cerebrovascular events (MACCE) within 1 year after PCI. The MACCE was defined as the composite of ischemia-driven TLR, all-cause death, non-fetal acute coronary syndrome, stroke, or heart failure requiring hospitalization. 

Results

A total of 206 patients undergoing PCI with DCB (55 patients with 58 lesions) or DES (151 patients with 158 lesions) were enrolled in this study. The procedural complication rate was 2.5 % in DES group and 1.7% in DCB group (P=1.000). After 1-year follow-up, the cumulative incidence of TLR was 5.5% in DCB group and 4.6% in DES group (P=0.522). The cumulative incidence of MACCE was 9.1% in DCB group and 12.6% in DES group (P=0.780). Only female gender, acute coronary syndrome on presentation, and DAPT duration < 3 months were significantly associated with MACCE at 1 year, but the use of DCB or DES was not.

Conclusion

The present study showed comparable outcomes between DCB and DES in de novo very small vessel PCI. Female gender and ACS at presentation and short DAPT < 3 months were predictive of worse outcome.