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Journal of Interventional Cardiology
Volume 2019, Article ID 6548696, 8 pages
https://doi.org/10.1155/2019/6548696
Research Article

Drug Coated Balloon-Only Strategy in De Novo Lesions of Large Coronary Vessels

1Klinikum Aschaffenburg-Alzenau, Medizinische Klinik 1, Aschaffenburg, Germany
2Medical Scientific Affairs, B. Braun Melsungen AG, Berlin, Germany
3Department of Cardiology and Internal Medicine, Charité–Universitätsmedizin Berlin, Campus Virchow, Berlin, Germany
4Pantai Hospital, Kuala Lumpur, Malaysia
5Pusat Perutban Universiti, Malaysia
6Ospedale San Giovanni di Dio, Italy
7The National Heart Institute of Malaysia, Malaysia
8Hospital Queen Elizabeth II, Malaysia
9Pusat Perutban Universiti Kebangsaan, Malaysia
10Espirito Santo Evora, Portugal
11CHU Montpellier, France
12Innere Medizin III, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Germany

Correspondence should be addressed to Mark Rosenberg; ed.zla-ba-mukinilk@grebnesor.kram

Received 5 November 2018; Revised 7 January 2019; Accepted 17 January 2019; Published 3 February 2019

Academic Editor: Gianluca Campo

Copyright © 2019 Mark Rosenberg et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives. We analyzed the efficacy of drug coated balloons (DCB) as a stand-alone-therapy in de novo lesions of large coronary arteries. DCBs seem to be an attractive alternative for the stent-free interventional treatment of de novo coronary artery disease (CAD). However, data regarding a DCB-only approach in de novo CAD are currently limited to vessels of small caliber. Methods. By means of propensity score (PS) matching 234 individuals with de novo CAD were identified with similar demographic characteristics. This patient population was stratified in a 1:1 fashion according to a reference vessel diameter cut-off of 2.75 mm in small and large vessel disease. The primary endpoint was the rate of clinically driven target lesion revascularization (TLR) at 9 months. Results. Patients with small vessel disease had an average reference diameter of 2.45 ± 0.23 mm, while the large vessel group averaged 3.16 ± 0.27 mm. Regarding 9-month major adverse cardiac event (MACE), 5.7% of the patients with small and 6.1% of the patients with large vessels had MACE (p=0.903). Analysis of the individual MACE components revealed a TLR rate of 3.8% in small and 1.0% in large vessels (p=0.200). Of note, no thrombotic events in the DCB treated coronary segments occurred in either group during the 9-month follow-up. Conclusions. Our data demonstrate for the first time that DCB-only PCI of de novo lesions in large coronary arteries (>2.75 mm) is safe and as effective. Interventional treatment for CAD without permanent or temporary scaffolding, demonstrated a similar efficacy for large and small vessels.