Deniz Mutlu, Athanasios Rempakos, Dimitrios Strepkos, Pedro E P Carvalho, Michaella Alexandrou, Eleni Kladou, Ozgur Selim Ser, Lorenzo Azzalini, Farouc A Jaffer, Luiz Ybarra, Omer Goktekin, Mahmut Uluganyan, Ramazan Ozdemir, Basem Elbarouni, Khaldoon Alaswad, Rhian Davies, Ahmed ElGuindy, Cuneyt Kocas, Sefa Sural, Paul Poommipanit, Jarrod Frizzel, Mir B Basir, Leah Raj, Laura Young, Bavana V Rangan, Olga C Mastrodemos, Jaskanwal Deep Singh Sara, Sandeep Jalli, Yader Sandoval, M Nicholas Burke, Emmanouil S Brilakis, Sevket Gorgulu
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引用次数: 0
Abstract
Background: There is limited information on the use of drug-coated balloons (DCBs) in chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Aims: To assess the frequency and outcomes of DCB use in CTO PCI.
Objective: This study evaluated the frequency and outcomes of DCB use in a large, multicenter CTO PCI registry.
Methods: We analyzed 12,146 patients who underwent 12,157 successful CTO PCIs at 59 centers from 2018 to 2025.
Results: DCBs were used in 454 patients (3.7%) with increasing frequency over time (p = 0.020). A DCB-only strategy was used in 48.4% of the patients and a hybrid strategy combining DCBs and drug-eluting stents (DES) was used in 51.6% of patients. Patients treated with DCB (both strategies) had low prevalence of comorbidities. Compared with the DES cases, DCB only cases had favorable angiographic characteristics, lower mean J-CTO (Japanese CTO) score (1.83 ± 1.03 vs. 2.27 ± 1.23; p < 0.001), and similar technical success (96.3% vs. 97.3%; p = 0.640), and in-hospital major adverse cardiac events (MACE). The hybrid and DCB-only strategies had comparable technical success and in-hospital MACE. During a median follow-up of 323 (170-429) days, DCB only cases had lower MACE than the other strategies (hazard ratio [HR] 0.41, 95% CI 0.17-0.96, p = 0.040). After multivariable adjustment, the association remained significant (HR 0.39, 95% CI 0.16-0.92, p = 0.032).
Conclusions: DCBs are increasingly being used in CTO PCI. A DCB only strategy was used in less complex lesions and was associated with similar technical success and in-hospital MACE compared with hybrid or DES strategies. A DCB only strategy was associated with lower long-term MACE.
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