Intracoronary Imaging Versus Coronary Angiography to Guide Drug-Coated Balloon Intervention in Coronary Artery...

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Devices

Background:

• Limited data exist on the clinical outcomes of intracoronary imaging (ICI)-guided drug-coated balloon (DCB) interventions.
• Drug-coated balloons are used to treat coronary artery disease, but optimal guidance strategies require further investigation.

Purpose of the Study:

• To evaluate the effect of ICI-guided DCB intervention on clinical endpoints compared to angiography-guided DCB intervention.
• To assess the incidence of target lesion failure (TLF) and cardiac death or target vessel myocardial infarction (MI) in patients undergoing DCB treatment.

Main Methods:

• A cohort study included 1157 patients with coronary artery disease treated with DCB.
• Patients were divided into ICI-guided (n=90) and angiography-guided groups.
• Primary endpoint was TLF (cardiac death, target vessel MI, target lesion revascularization); secondary endpoint was cardiac death or target vessel MI. Propensity score analysis was used.

Main Results:

• No statistically significant difference in TLF rates between ICI-guided (12.2%) and angiography-guided (12.5%) groups (P = .80).
• Cardiac death or target vessel MI rates were numerically lower in the ICI-guided group (1.1% vs 3.7%, P = .17).
• Propensity score analysis showed a trend towards lower TLF (10.5% vs 16.2%, P = .19) and cardiac death or MI (1.2% vs 2.3%, P = .51) with ICI guidance.

Conclusions:

• In this observational study, ICI-guided DCB treatment showed a trend towards decreased TLF compared to angiography-guided procedures.
• While not statistically significant, the numerical reduction in adverse events suggests potential benefits of ICI guidance.
• Larger prospective studies are warranted to confirm the efficacy of ICI-guided DCB interventions.