Treatment Of Small Vessel De Novo Lesions With Drug Coated Balloon

Objective:Durg eluting stent(DES: durg eluting stent)significantly reduces the restenosis rate compared to bare metal stent(BMS: bare metal stent),however,the application of DES in certain clinical settings,such as small vessel disease,is still barely satisfactory.Drug coated balloon(DCB: drug coated balloon)is effective and feasible in ISR lesions?However,the efficacy of DCB in small vessel disease needs to be established.So we conducted this retrospective study to evaluate the efficacy of DCB in small vessel de novo lesions.Method:167 consecutive patients(177 lesions)with small vessel disease were enrolled from April 2014 to April 2017 and two of them were patients with chronic total occlusion.Results:There was no statistical difference between the post-procedure and angiographic follow-up MLA(MLA:minimum lumen area)(1.28±0.46 mm vs.1.30±0.24 mm,P=0.756).The late lumen loss is only 0.02±0.41 mm.A lumen increase was found in 15 lesions and the late lumen gain was 0.31±0.39 mm in this subgroup.Restenosis occurred in 2 patients and the incidence of restenosis is 6.5%.Myocardial infarction(not lesion related)occurred in 3 patients and target lesion revascularization in 3 patients.The incidence of MACE(MACE: major adverse cardiovascular events)is only 5.6%(n=7).Conclusion:1 There was no statistical difference between the post-procedure and angiographic follow-up minimal lumen diameter.2 Part of patients with small vessel disease treated with drug coated balloon will show positive vessel remodeling.3 drug coated balloon seem to be safe and effective in small vessel disease and even increase vascular lumen.A drug coated balloon-only approach might be an alternative strategy to drug eluting stent.