Natural history of coronary plaque redistribution after drug-coated balloon angioplasty

While there is growing interest in a “leave nothing behind” percutaneous coronary intervention (PCI) strategy using drug‐coated balloons (DCB), accurate evaluation of DCB-treated lesions remains critical after PCI. The advent and continued evolution of advanced computed tomography (CT) technologies, including photon-counting CT (PCCT), with markedly improved temporal and spatial resolution, enable increasingly precise, non-invasive monitoring of patients following DCB PCI.1

We present three cases of de novo coronary chronic total occlusion patients undergoing PCI using a DCB-only strategy, with baseline and follow-up coronary CT angiography (CCTA), each employing a different generation of CT modalities. The first patient was scanned on conventional CT, the second patient was scanned using PCCT, and the third patient was scanned on PCCT in high-resolution mode (Supplementary Figure 1). Computed tomography acquisition and reconstruction parameters were unchanged pre- and post-PCI, and quantitative coronary plaque analysis was performed automatically (Autoplaque, version 3.0 [Cedars-Sinai]).2 In each case a paclitaxel-eluting balloon (SeQuent Please NEO [B. Braun]) was used (inflation time of 60-90 seconds each, balloon-to-vessel ratio of 0.92 to 1.0). The study complied with the Declaration...