Safety And Efficacy Of Post-dilatation With Single Noncompliant Balloon After Multiple Stents Implantation For Long Coronary Artery Lesions

Objectives: Post-dilatation with noncompliant balloon can efficaciously reduced the rates of restenosis and stent thrombosis after stents implantation for long coronary artery lesions.However,there are few studies about the outcomes of post-dilatation strategies in long coronary vessels with different proximal and distal reference diameters(taper-off vessel with ΔD ≥ 0.5 mm).This study aimed to explore the safety and efficacy of post-dilatation with single noncompliant balloon after multiple stents implantation for long coronary artery lesions with different proximal and distal reference diameters in the real world.Methods: This was a single center retrospective cohort study.301 patients with ΔD≥ 0.5 mm,who underwent percutaneous coronary intervention,were divided into 2 groups of single balloon group(SB group,n=212)or multiple balloons group(MB group,n=89)according to the number of balloons used in post-dilatation.Primary end points were minimal lumen diameter(MLD)at 9-12 months,and the secondary end points were complications and major adverse cardiac events(death,myocardial infarction,and target-lesion/vessel revascularization)in hospital,at 6-month and at 12-month.The target vessel size and diameter stenosis percentage were determined by quantitative coronary angiographic analysis(QCA).Results: Baseline clinical characteristics were comparable in both groups.There was no significant difference in lesion length and the difference between proximal and distal vessels diameters between the groups.Total fluoroscopy time and product of radiological dose area in the SB group were less than in the MB group,respectively(21.6±11.27 min vs 24.9±12.17 min,p = 0.005;20373.3±11843.77 μGym2 vs 29553.5±45002.88μGym2,p = 0.004).Post-procedural QCA shown there was no significant difference in MLD,RVD or residual stenosis(in-lesion,in-stent or insegment)between the groups.At 9-12 months follow up,the primary end point(MLD)showed no significant difference between the groups(2.42±0.63 mm vs 2.53±0.54 mm,p=0.26),with no differences in the secondary end points of procedural complications and 12 month cumulative MACEs(2.3% vs 0%,p=0.33).Conclusion: Post-dilatation with single noncompliant balloon after multiple stents implantation for the taped-off long coronary artery lesions is safe and effective and could be considered clinically.