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Estrategia híbrida (DES + DCB) para oclusiones totales crónicas: Desarrollo de la puntuación de estratificación de
Ehab Cherif1, Husam Abdulaziz Noor1
1Mohammed Bin Khalifa Cardiac Centre (MKCC), Royal Medical Services (RMS), Bahrain.
Background:
Hybrid drug-eluting stent/drug-coated balloon percutaneous coronary intervention (DES-DCB PCI) aims to minimize stent burden while maintaining patency in chronic total occlusion lesions.
Methods:
We prospectively studied 19 consecutive CTO patients treated with a hybrid DES-DCB strategy; primary endpoint was late lumen loss (LLL) at 3-4 months, with secondary clinical outcomes at six months.
Results:
Technical success was 89.5 %; mean LLL was 0.10 ± 0.83 mm; late lumen gain occurred in ~53 % of patients completing angiographic follow-up; binary restenosis was 10.5 %. Residual stenosis strongly predicted LLL, while optimal DCB sizing and inflation ≥180 s were protective; residual stenosis remained the independent predictor in multivariable regression. IVUS guidance was associated with 0 % restenosis.
Conclusions:
Hybrid DES-DCB PCI for CTOs was feasible with low LLL. Outcomes hinged on lesion preparation, sizing, and inflation duration. The six-component GLOW score provides intra-procedural risk stratification and warrants multicenter validation.
