Efficacy Of Drug-Coated Balloon For De Novo Small Vessel Lesion Of Coronary Artery

Objective: To study the efficacy and safety of paclitaxel-coated balloon for de novo small vessel lesions.Method: a retrospective analysis was made of 104 patients who were treated with drug coated balloon in the coronary artery by coronary angiography in the Department of Cardiology of yijishan hospital and its associated hospital of Wannan Medical College from October 2017 to June 2019.The patients were followed up for 9-12 months,including the failure rate of target lesion(TLF),the rate of target lesion revascularization(TLR),the rate of major adverse cardiac events(MACE)and mortality;After that,quantitative coronary angiographic analysis(QCA)was used to measure the minimum lumen diameter(MLD)of patients before,after and after operation.Results: a total of 104 patients,aged 61.84±10.31 years,were enrolled,including 72(69.2%)men,82(78.9%)hypertension,24(23.1%)diabetes mellitus,41(39.4%)smoking history,28(27.0%)drinking history,21(20.2%)PCI history,41(39.4%)stable angina,51(49.0%)unstable angina,ECG The results showed that there were 68(65.4%)patients with ST-T changes,59(56.7%)patients with coronary artery calcification,the average length of the target lesion was 12.36±5.06 mm,the average diameter and length of the pre expanded balloon were 2.45± 0.3mm and 14.03±2.96 mm,the average stenosis degree of the target vessel was 88.86±7.38%,the average diameter and length of the drug balloon were 2.51±0.29 mm and 24.08±4.45 mm,respectively the mean filling pressure was 7.97±1.04 atm,the average balloon filling time was 58.70 ± 3.19 seconds.During 9-12 months of clinical follow-up,there were 3(2.9%)cases of target lesion failure(TLF),0(0.0%)cases of cardiac death,0(0.0%)cases of target myocardial infarction,3(2.9%)cases of target lesion revascularization(TLR),5(4.8%)cases of non target revascularization,0(0.0%)cases of target thrombosis,and mace event cases were 5(4.8%)and 2(1.9%)had recurrent chest pain.The preoperative and postoperative MLD measured by QCA were 0.66±0.37 mm and 2.33±0.46 mm,respectively,with significant difference(P < 0.01);the MLD measured by contrast-enhanced follow-up was 2.28±0.50 mm,with no significant difference(P = 0.838).Conclusion: Paclitaxel-coated balloon can immediately increase lumen acquisition and hasn’t obvious late lumen loss that has certain efficacy and safety in the treatment of small vessel lesions in situ.