Comparison of angiographic change in side-branch ostium after drug-coated balloon vs. drug-eluting stent vs....

Area of Science:

• Interventional Cardiology
• Vascular Biology
• Biomaterials Science

Background:

• Coronary bifurcation lesions present unique challenges for percutaneous intervention.
• Limited data exist on the specific impact of drug-coated balloons (DCB) on side-branch (SB) ostial effects after treatment.
• Understanding these effects is crucial for optimizing treatment strategies in complex coronary anatomies.

Purpose of the Study:

• To investigate the angiographic outcomes of the side-branch (SB) ostium following drug-coated balloon (DCB) treatment.
• To compare these outcomes against drug-eluting stent (DES) implantation and optimal medical therapy (OMT) in the main vessel (MV) for de novo coronary bifurcation lesions.

Main Methods:

• A comparative analysis of serial angiographic changes in the SB ostium was performed.
• Three treatment groups were evaluated: DCB, DES, and OMT for main vessel intervention.
• The change in lumen diameter and diameter stenosis was calculated by subtracting pre-procedure values from follow-up values.

Main Results:

• The DCB group showed an increase in minimal lumen diameter (MLD) of the SB ostium at follow-up.
• Conversely, both DES and OMT groups exhibited a decrease in SB ostium MLD.
• Diameter stenosis (DS) of the SB ostium significantly decreased in the DCB group, unlike the increase seen in DES and OMT groups.

Conclusions:

• Drug-coated balloon treatment of the main vessel in de novo coronary bifurcation lesions leads to favorable angiographic outcomes at the side-branch ostium.
• These positive effects were observed at 6-9 month follow-up when compared to drug-eluting stent implantation or optimal medical therapy.
• DCB emerges as a potentially superior strategy for managing the side-branch ostium in bifurcation interventions.