Original Research

DOI: 10.4244/EIJ-D-23-01006

Predictors of target lesion failure after percutaneous coronary intervention with a drug-coated balloon for de novo lesions

Tetsumin Lee1, MD, PhD; Takashi Ashikaga1, MD, PhD; Toshihiro Nozato1, MD, PhD; Yasutoshi Nagata1, MD; Masakazu Kaneko1, MD, PhD; Ryoichi Miyazaki1, MD; Toru Misawa1, MD; Yuta Taomoto1, MD; Shinichiro Okata1, MD, PhD; Masashi Nagase1, MD; Tomoki Horie1, MD; Mao Terui1, MD; Daigo Kachi1, MD; Yuki Odanaka1, MD; Kazuki Matsuda1, MD; Michihito Naito1, MD; Ayaka Koido1, MD; Taishi Yonetsu2, MD, PhD; Tetsuo Sasano2, MD, PhD

Abstract

BACKGROUND: There are limited data about determinant factors of target lesion failure (TLF) in lesions after percutaneous coronary intervention (PCI) using a drug-coated balloon (DCB) for de novo coronary artery lesions, including optical coherence tomography (OCT) findings.

AIMS: The present study aims to investigate the associated factors of TLF in de novo coronary artery lesions with DCB treatment.

METHODS: We retrospectively enrolled 328 de novo coronary artery lesions in 328 patients who had undergone PCI with a DCB. All lesions had been treated without a stent, and both pre- and post-PCI OCT had been carried out. Patients were divided into two groups, with or without TLF, which was defined as a composite of culprit lesion-related cardiac death, myocardial infarction, and target lesion revascularisation, and the associated factors of TLF were assessed.

RESULTS: At the median follow-up period of 460 days, TLF events occurred in 31 patients (9.5%) and were associated with patients requiring haemodialysis (HD; 29.0% vs 10.8%), with a severely calcified lesion (median maximum calcium arc 215° vs 104°), and with the absence of OCT medial dissection (16.1% vs 60.9%) as opposed to those without TLF events. In Cox multivariable logistic regression analysis, HD (hazard ratio [HR]: 2.26, 95% confidence interval [CI]: 1.00-5.11; p=0.049), maximum calcium arc (per 90°, HR: 1.34, 95% CI: 1.05-1.72; p=0.02), and the absence of post-PCI medial dissection on OCT (HR: 8.24, 95% CI: 3.15-21.6; p<0.001) were independently associated with TLF.

CONCLUSIONS: In de novo coronary artery lesions that received DCB treatment, factors associated with TLF were being on HD, the presence of a severely calcified lesion, and the absence of post-PCI medial dissection.

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Volume 20 Number 13
Jul 1, 2024
Volume 20 Number 13
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