Immediate Effect of Drug-Eluting Balloon Angioplasty Combined With Cutting Balloon Predilatation for the Treatment of Coronary Artery Disease

Abstract

Background

Cutting balloon (CB) can reduce vascular inflammation and elastic recoil, and these findings have been verified in combination with stent implantation in patients with coronary artery disease (CAD). This study aims to compare the immediate effect of CB with conventional balloon pre-dilatation before drug-eluting balloon (DEB) angioplasty for the treatment of CAD.

Methods

Patients with CAD, diagnosed by elective coronary angiography and having either de novo lesions or in-stent restenosis (ISR) were included. All patients were randomly assigned to undergo predilatation with either a CB or a conventional balloon prior to DEB treatment. We assessed the immediate effect and the level of inflammatory factors after the operation between two groups.

Results

Eighty-five patients were enrolled. In the CB group (n = 42), all patients achieved residual stenosis  < 30% (100% procedural success), with no acute complications observed. In the conventional balloon group (n = 43), 6 patients had residual stenosis  ≥ 30% (resulting in an 86.0% procedural success rate), and two acute complications occurred (one type B dissection and one acute branch occlusion), neither requiring bail-out stenting. Moreover, serum levels of IL-6, IL-8, TNF-α, and CRP at 24 h were significantly higher than those before and immediately after the operation in the two groups. The degrees of increase in concentration of IL-6, IL-8, and TNF-α 24-h postoperatively were lower in the CB group than those in the conventional balloon group (P < 0.05).

Conclusions

In the treatment of CAD with DEB angioplasty, predilatation with CB was associated with improved immediate procedural success and a reduced inflammatory response compared with conventional balloon predilatation.