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Drug-eluting vs. conventional balloon for side branch dilation in coronary bifurcations treated by provisional T
Juan A Herrador1, Juan C Fernandez, Manuel Guzman
1Unidad de Hemodinámica, Servicio de Cardiología, Complejo Hospitalario de Jaén, Jaén, Spain.
Objective:
The origin of the side branch (SB) is the most common site for restenosis in coronary bifurcations. The end-point is to compare the results of SB dilation with drug-eluting balloon (DEB group) versus conventional balloon (BAL group) in bifurcations treated with provisional T stenting.
Methods And Results:
Each group included 50 patients. In DEB, the origin of SB was dilated with a Sequent(®) Please balloon. In both groups, a Taxus Liberté(®) stent was implanted in the main vessel, with kissing balloon postdilation. If the outcome for the SB was suboptimal, a Taxus stent was implanted in BAL and a bare stent in DEB group. An angiographic follow-up and IVUS were scheduled for 12 months later. Adverse events (MACE) were 24% in BAL versus 11% in DEB (P = 0.11), with greater revascularization (TLR) in the BAL group (22% vs. 12%, P = 0.16). At angiographic follow-up, there was a lower percentage of SB restenosis in the DEB group (20% vs. 7%, P = 0.08), with less late loss (0.40 mm vs. 0.09 mm, P = 0.01).
Conclusion:
Side branch dilation with a drug-eluting balloon resulted in better angiographic outcomes than with a conventional balloon, with less late loss and restenosis at the 12-month follow-up.
