E-Abstract

JACC

Lots of interesting abstracts and cases were submitted for TCTAP 2023. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!

TCTAP A-043

Precise Assessments of Dissection Following Drug-Coated Balloon Treatment and Its Impact on Clinical Outcomes in de Novo Small Vessel Disease

By Kai Ninomiya, Patrick W. Serruys, Jiayue Huang, Shinichiro Masuda, Daixin Ding, Nozomi Kotoku, Shigetaka Kageyama, Shengxian Tu, William Wijns, Jouke Dijkstra, Sandeep Basavarajaiah, Antonio Colombo, Yoshinobu Onuma

Presenter

Kai Ninomiya

Authors

Kai Ninomiya1, Patrick W. Serruys2, Jiayue Huang2, Shinichiro Masuda2, Daixin Ding2, Nozomi Kotoku2, Shigetaka Kageyama2, Shengxian Tu3, William Wijns2, Jouke Dijkstra4, Sandeep Basavarajaiah5, Antonio Colombo6, Yoshinobu Onuma2

Affiliation

Iwate Medical University, Japan1, University of Galway, Ireland2, Shanghai Jiao Tong University, China3, Leiden University Medical Center, Netherlands4, University Hospital Birmingham, United Kingdom5, EMO GVM Centro Cuore Columbus, Italy6
View Study Report
TCTAP A-043
Drug-Eluting Balloons

Precise Assessments of Dissection Following Drug-Coated Balloon Treatment and Its Impact on Clinical Outcomes in de Novo Small Vessel Disease

Kai Ninomiya1, Patrick W. Serruys2, Jiayue Huang2, Shinichiro Masuda2, Daixin Ding2, Nozomi Kotoku2, Shigetaka Kageyama2, Shengxian Tu3, William Wijns2, Jouke Dijkstra4, Sandeep Basavarajaiah5, Antonio Colombo6, Yoshinobu Onuma2

Iwate Medical University, Japan1, University of Galway, Ireland2, Shanghai Jiao Tong University, China3, Leiden University Medical Center, Netherlands4, University Hospital Birmingham, United Kingdom5, EMO GVM Centro Cuore Columbus, Italy6

Background

Several studies have shown favorable or unfavorable effects of dissection following drug-coated balloon (DCB) angioplasty. However, there is no established method to precisely assess the dissection during DCB treatment, and the relationship between the dissection and late lumen gain (LLG) remains unclear.

Methods

The present study consisted of patients enrolled in the TRANSFORM-I trial, which is a randomized trial comparing novel Magic TouchTM sirolimus coated-balloon with SeQuent Please NeoTM paclitaxel-coated balloon in patients with de-novo small vessel coronary artery diseases.100 lesions in 98 patients were investigated with OCT after pre-dilatation to assess the dissection. A customized software (QCU-CMS, Leiden) precisely quantifies the dissection and lumen volumes separated by a common boundary connecting the two edges of the intimal fracture (Figure). Quantitative OCT analysis of dissection volume is derived from cross-sectional slices with a thickness of 200 microns using the Simpsons rule.The tissue composition analysis, using OctPlus software (Pulse, Shanghai) and QCU-CMS, at the starting site of the dissection was performed to elucidate the mechanisms triggering the dissection. Finally, the relationship between the quantified dissection volume and late lumen loss (LLL) or LLG at 6-month angiography was investigated.

Results

The dissection was found in 96% (96/100) of the treated lesions. The median dissection volume was 1.98 mm3. The median maximal dissection arc was 113 degrees. The tissue composition analysis showed that the dissection occurs at the thinnest site (320 μm) of fibrous intima (83%).

Conclusion

Dissection occurs frequently during DCB treatment and we developed a new method to quantify the dissection precisely. Final results with 6-month outcome, the relationship between the dissection and LLL/LLG, will be presented at the time of congress.