Possible mechanism of late lumen enlargement after treatment for de novo coronary lesions with drug-coated balloon
| Autor: | Hiroya Kawai, Yoshinori Yasaka, Tomofumi Takaya, Kenzo Uzu, T. Yamamoto, Takahiro Sawada |
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| Rok vydání: | 2020 |
| Předmět: |
Drug coated balloon
Lumen (anatomy) Coronary Artery Disease 030204 cardiovascular system & hematology Balloon Coronary Angiography Lesion Coronary artery disease 03 medical and health sciences 0302 clinical medicine Intravascular ultrasound medicine Humans 030212 general & internal medicine Angioplasty Balloon Coronary Ultrasonography Interventional medicine.diagnostic_test business.industry medicine.disease Coronary Vessels Predictive factor Treatment Outcome Pharmaceutical Preparations medicine.symptom Cardiology and Cardiovascular Medicine Nuclear medicine business After treatment |
| Zdroj: | International journal of cardiology. 321 |
| ISSN: | 1874-1754 |
| Popis: | Background Drug-coated balloon (DCB) treatment for de novo coronary artery disease has demonstrated late lumen enlargement (LLE) in mid-term follow-up and it was considered as clinical benefit; however, its mechanism and the predictive factor remains unclear. Methods This study enrolled 46 consecutive patients (54 lesions) treated with DCB, using intravascular ultrasound (IVUS) at the index procedure and at the 9-month follow-up. We measured IVUS parameters at 1-mm intervals and calculated the mean volume of the external elastic membrane (EEM), lumen, and plaque. We calculated the dissection index (DI) defined as summation of the following points, 2: dissection over EEM, 1: intra-EEM dissection, 0: no dissection at every 1-mm interval, and divided by lesion length. Results IVUS showed that there was no flow limiting dissection just after DCB treatment, the mean EEM and lumen volume (LV) had significantly increased while mean plaque volume had significantly decreased at 9 months, and 74.1% lesions exhibited LLE. We divided the patients into three groups according to delta mean LV. Mean EEM volume significantly increased and mean plaque volume significantly decreased in the larger and smaller LLE groups, but not in the non-LLE group. The DI was higher in a descending order in the three groups. The multiple regression analysis demonstrated that the DI was the strongest predictor of the change in mean LV. Conclusions LLE after DCB treatment may be caused by vessel enlargement and plaque regression. The non-flow limiting larger dissection just after DCB treatment may strongly associate with the intending LLE. |
| Databáze: | OpenAIRE |
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