Cardiovascular Revascularization Medicine最新文献

{"title":"DK-crush versus mini-crush for complex coronary bifurcation lesions: A systematic review and meta-analysis.","authors":"Sunny Goel, Andy Moyal, George Dangas, Annapoorna S Kini, Samin K Sharma","doi":"10.1016/j.carrev.2026.08.010","DOIUrl":"https://doi.org/10.1016/j.carrev.2026.08.010","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Device shifting and embolization of a new generation percutaneous left atrial appendage occluding device. Novel insights on Watchman FLX PRO.","authors":"Ali Bahbah, Ehab Aboelsoud, Mai Badr, Kerollos Abdelsayed, John Ambrose, Chandra K Katikireddy, Robert Hauser, Michael Shehata","doi":"10.1016/j.carrev.2026.08.011","DOIUrl":"https://doi.org/10.1016/j.carrev.2026.08.011","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanical versus bioprosthetic valves in aortic root replacement for acute type A dissection.","authors":"Takuya Ogami, Christopher Pantelis, Francis D Ferdinand, Xander Jacquemyn, Danny Chu, Derek Serna-Gallegos, Ibrahim Sultan","doi":"10.1016/j.carrev.2026.08.007","DOIUrl":"https://doi.org/10.1016/j.carrev.2026.08.007","url":null,"abstract":"<p><strong>Background: </strong>Aortic root replacement with a prosthetic valve is often required during type A aortic dissection repair (TAAD). With the advent of transcatheter aortic valve replacement (TAVR), the use of bioprosthetic valves has increased.</p><p><strong>Methods: </strong>Patients undergoing acute TAAD repair from January 2007 through January 2025 were identified. Those who underwent aortic root replacement with a prosthetic valve were included. Multivariable Cox proportional hazards modeling was performed to evaluate the association between valve type and long-term mortality.</p><p><strong>Results: </strong>Of the 587 patients who underwent type A aortic dissection repair, 158 patients received a prosthetic valve during root replacement. Mechanical valves (MV) were used in 74 (46.8%) and bioprosthetic valves (BV) in 84 (53.2%). The MV group was younger (51.6 vs. 65.3 years, P < 0.001), with similar rates of malperfusion syndromes between groups. 30-day mortality was 8.2% and comparable between the groups. Reoperation for bleeding was more frequent in the MV group but not statistically different (8.5% vs. 4.8%, P = 0.51). Cox Hazard analysis showed that bioprosthetic valve was independently associated a higher risk for long-term mortality (HR 3.23, 95% CI 1.39-7.69, P < 0.001).</p><p><strong>Conclusion: </strong>While reoperation for bleeding was more observed in patients receiving a mechanical valve, a bioprosthetic valve was associated with a higher risk for long-term mortality. While valve choice may not be available to patients in emergent high acuity situations, it is relevant when surgeons make decisions regarding appropriate prosthesis in patients undergoing surgery for acute TAAD.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GI bleeding complicating PCI: Trends, outcomes, and a paradoxical decline in endoscopy utilization.","authors":"Adrian Nubla, Keerthana Manjunath, Marco Dispagna, Jennifer Cabrera, Revati Varma, Hugo Lopez-Arevalo, Bilal Bajwa","doi":"10.1016/j.carrev.2026.08.008","DOIUrl":"https://doi.org/10.1016/j.carrev.2026.08.008","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal bleeding (GIB) is a feared complication of percutaneous coronary intervention (PCI), carrying significant morbidity and mortality. Updated national data on trends in prevalence, management patterns, and outcomes across patient subgroups are lacking.</p><p><strong>Methods: </strong>We analyzed the National Inpatient Sample (2016-2022), identifying ACS/CAD-related PCI admissions with GIB using ICD-10-CM codes. Survey-weighted multivariable logistic regression adjusted for demographics, comorbidities, and hospital characteristics. Inverse probability of treatment weighting (IPTW) served as the primary sensitivity analysis. Temporal trends in GIB prevalence, subtype, endoscopy use, and transfusion rates were assessed by calendar year.</p><p><strong>Results: </strong>Among 3,231,885 weighted PCI admissions, GIB occurred in approximately 2.1%. GIB was associated with higher in-hospital mortality (multivariable adjusted odds ratio [aOR] 3.393; IPTW aOR 5.165; both P < 0.001), with lower GIB carrying higher mortality than upper GIB (aOR 3.069 vs 1.581). GIB was also associated with 5.42 additional hospital days and $18,974 higher costs after IPTW adjustment (both P < 0.001). Despite stable prevalence, upper endoscopy use declined significantly (OR per year 0.959, P = 0.006) and was independently associated with lower mortality (aOR 0.702, 95% CI 0.587-0.839), P < 0.001). Black and Hispanic patients had higher odds of GIB (all aOR >1.2, P < 0.001).</p><p><strong>Conclusions: </strong>GIB complicates approximately 1 in 50 PCI admissions and is associated with substantially higher mortality, prolonged hospitalization, and excess costs. Declining endoscopy utilization despite an observed mortality benefit may represent a quality improvement opportunity. Higher mortality associated with lower GIB warrants further investigation.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conduction disturbance recovery and permanent pacing requirement in bicuspid aortic valves post-TAVR.","authors":"Iad Alhallak, Xena Moore, Ken Chan, Biswajit Kar, Richard Smalling, Alejandro Vidal Margenat, Abhijeet Dhoble","doi":"10.1016/j.carrev.2026.08.006","DOIUrl":"https://doi.org/10.1016/j.carrev.2026.08.006","url":null,"abstract":"<p><strong>Background and purpose: </strong>Conduction disturbances (CD) are a common complication of transcatheter aortic valve replacement (TAVR), and patients with bicuspid aortic valves (BAV) seem particularly vulnerable. Whether temporary CD recover or progress to permanent pacemaker (PPM) implantation is poorly characterized in patients with BAV. We characterized recovery from intra-procedural conduction injury and predictors of recovery versus progression to permanent pacing.</p><p><strong>Methods: </strong>We retrospectively analyzed 307 BAV patients without prior PPM who underwent TAVR at a single center (February 2014-June 2025). Multivariable models were adjusted for age, sex, prior atrial fibrillation, coronary artery disease, aortic-valve calcium volume, and device type; peripheral vascular disease was added in the within-TempPM Firth-penalized model owing to complete separation.</p><p><strong>Results: </strong>Temporary pacemaker (TempPM) placement was required in 60 patients; 28 (46.7%) recovered without PPM. Peripheral vascular disease (PVD) was the strongest predictor of non-recovery (p = 0.027), with prior atrial fibrillation showing a similar trend (p = 0.053). Sievers Type 1, specifically the left-right coronary-fusion subtype (L-R), showed higher TempPM use (OR 7.18, p = 0.003). Self-expanding valves also increased TempPM risk (OR 4.41, p = 0.012). Among patients without peri-procedural CD, delayed PPM (11, 4.5%) was predicted only by advanced age (OR 1.08, p = 0.035).</p><p><strong>Conclusions: </strong>Nearly half of BAV patients with peri-procedural conduction injury recover without permanent pacing, supporting extended monitoring before committing to PPM implantation. Peripheral vascular disease and prior atrial fibrillation identify patients unlikely to recover and may guide earlier PPM placement. Sievers Type 1 L-R morphology and advanced age are associated with conduction risk and should inform pre-procedural planning.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity as a determinant of radiation burden in the cardiac catheterization laboratory.","authors":"Shaun Khanna, David Burgess, Gopal Sivagangabalan, Ajay J Kirtane, Nitesh Nerlekar, Eugenio Picano, Patrick W Serruys, Aditya Bhat","doi":"10.1016/j.carrev.2026.08.002","DOIUrl":"https://doi.org/10.1016/j.carrev.2026.08.002","url":null,"abstract":"<p><p>Patient obesity is now a common characteristic in the cardiac catheterisation laboratory, yet its impact on radiation exposure remains under-recognised. Increased body mass index impairs X-ray penetration, prompting fluoroscopy systems to increase radiation output to maintain image quality. Consequently, patients with obesity receive substantially higher radiation doses across coronary, electrophysiological, haemodynamic, and structural heart procedures, while operators experience disproportionate increases in scatter radiation, creating cumulative occupational risk. Obesity also increases procedural complexity through more challenging vascular access, prolonged fluoroscopy, suboptimal shielding, and steeper imaging projections, further amplifying radiation burden. This review synthesises current evidence demonstrating obesity as a major procedural determinant of radiation exposure and proposes a practical obesity-aware framework incorporating fluoroscopy optimisation, shielding strategies, real-time dosimetry, enhanced radiation protection devices, workflow adaptations, and institutional quality improvement. Recognising body habitus as a core procedural variable is essential to improving radiation safety for both patients and healthcare workers while informing future obesity-specific radiation protocols.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-month versus twelve-month dual antiplatelet therapy after acute coronary syndrome: An updated meta-analysis of randomized trials with trial sequential analysis.","authors":"Christopher Chinnatambi, Abdul Rahaman Ottun, Louise Sakowski, Prince Darko, Baffour Otchere, Abdul-Daaim Mohammed-Murtala, Sammudeen Ibrahim, Andrew Klein, Uzoma Ibebuogu, Triston Smith, Sudhir Mungee","doi":"10.1016/j.carrev.2026.08.004","DOIUrl":"https://doi.org/10.1016/j.carrev.2026.08.004","url":null,"abstract":"<p><strong>Background: </strong>The optimal duration of dual antiplatelet therapy (DAPT) after acute coronary syndrome (ACS) treated with percutaneous coronary intervention (PCI) remains uncertain. Advances in stent design and the use of potent P2Y₁₂ inhibitors have reduced thrombotic risk, raising questions about whether prolonged DAPT continues to provide incremental benefit.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) enrolling exclusively ACS patients undergoing PCI who were randomized to 3-month versus 12-month DAPT. Coprimary outcomes were major adverse cardiovascular and cerebrovascular events (MACCE) and clinically relevant bleeding (CRB). Secondary outcomes included all-cause mortality, myocardial infarction, stroke, stent thrombosis, target-vessel revascularization, and net adverse clinical events (NACE; MACCE + CRB). Trial sequential analysis (TSA) was performed to evaluate the conclusiveness of evidence for each coprimary outcome.</p><p><strong>Results: </strong>Seven RCTs encompassing 17,515 patients (mean age 63 years; 31% women; 45% STEMI) were included. Abbreviated 3-month DAPT did not differ from 12-month therapy for MACCE (5.6% vs 5.7%; risk ratio [RR], 0.96; 95% CI, 0.79-1.17; I² = 44%), but significantly reduced CRB (3.0% vs 4.9%; RR, 0.62; 95% CI, 0.50-0.76; I² = 31%), corresponding to an absolute risk reduction of 1.9% and number needed to treat of 52. NACE was lower with abbreviated therapy (7.9% vs 9.7%; RR, 0.81; 95% CI, 0.66-1.00). TSA crossed the futility boundary for MACCE and the benefit boundary for CRB, indicating conclusive evidence for bleeding reduction and futility for ischemic benefit.</p><p><strong>Conclusions: </strong>Among ACS patients treated with contemporary DES, 3-month DAPT followed by monotherapy significantly reduces bleeding without increasing ischemic events. TSA confirms the conclusiveness of current evidence, supporting abbreviated DAPT as a safe and effective default strategy in appropriately selected ACS patients.</p><p><strong>Registration: </strong>The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with unique identifier CRD420251143351 and URL: https://www.crd.york.ac.uk/prospero/search.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug-coated balloon (SeQuent please neo) versus drug-eluting stent treatment for acute ST-elevation myocardial infarction: Design and rationale of the STEMI DCB trial.","authors":"Christopher J Broyd, James Cockburn, Joao Martins, Timothy Bagnall, Mohammed Abouelasaad, Paul Bassett, Jessica Parker, Jeremy P Langrish, Jonathan Rawlins, Bernard Prendergast, Jonathan Hinton, Simon Eccleshall, David Hildick-Smith","doi":"10.1016/j.carrev.2026.08.003","DOIUrl":"https://doi.org/10.1016/j.carrev.2026.08.003","url":null,"abstract":"<p><p>Primary percutaneous coronary intervention (PCI) is the established gold-standard treatment for ST-elevation myocardial infarction (STEMI), but stent implantation confers an appreciable long-term failure rate driven by impaired vasomotion, neoatherosclerosis and late stent thrombosis. Drug-coated balloons (DCB) allow a leave-nothing-behind strategy that may optimise short- and long-term outcomes in this high-risk population, but no adequately powered randomised trial has compared a DCB-only strategy with drug-eluting stents (DES) in STEMI using an all-comers design with randomisation prior to diagnostic angiography. The STEMI DCB trial is an investigator-initiated, multi-centre, prospective, open-label, 1:1 randomised non-inferiority trial conducted across 15 United Kingdom sites (ISRCTN16341009), recruiting 700 patients presenting for primary angioplasty who will be randomised to a DCB-only strategy (SeQuent Please Neo) or DES prior to diagnostic angiography. An emergency consent process, followed by formal written consent before discharge, allows near-complete enrolment of this acute population. The primary endpoint is Target Vessel Failure (TVF), a composite of cardiovascular death and target vessel myocardial infarction or revascularisation, assessed for non-inferiority at 1 year with superiority testing if non-inferiority is met; patients will be followed to 8 years. By randomising before coronary anatomy is known, the STEMI DCB trial avoids the selection bias inherent in trials that randomise after angiography and restoration of flow, providing a true all-comers comparison of these strategies. This trial will provide the first adequately powered evidence on whether a DCB-only strategy is non-inferior to DES for STEMI, with potential to materially change primary PCI practice worldwide.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Off-label use of microaxial left ventricular assist devices is associated with higher mortality despite use in younger patients with fewer comorbidities.","authors":"Sarah J Murphy, Stephen Brand, Dan Neal, Rick Kerensky, Jeet Mehta, Amit Badiye, Khanjan B Shah","doi":"10.1016/j.carrev.2026.08.005","DOIUrl":"https://doi.org/10.1016/j.carrev.2026.08.005","url":null,"abstract":"<p><strong>Background: </strong>Microaxial left ventricular assist devices (Impella CP, Johnson & Johnson) are FDA-approved for cardiogenic shock, COVID-19 requiring extracorporeal membrane oxygenation (ECMO), and high-risk percutaneous coronary intervention (HRPCI). Clinicians may also use Impella CP devices off-label, but real-world outcomes data on off-label use is limited. We examined national trends and comparative outcomes associated with off-label versus on-label Impella CP device use.</p><p><strong>Methods: </strong>The Healthcare Cost and Utilization Project National Inpatient Sample was analyzed for adult hospitalizations containing ICD-10 codes for Impella CP from October 1, 2015 to December 31, 2022. Admissions with ICD-10 codes for cardiogenic shock, COVID-19 with ECMO, or HRPCI were classified as on-label; all others were classified as off-label. The primary outcome was in-hospital mortality. Secondary outcomes were limb revascularization, access site bleeding, hospital length of stay (LOS), and discharge home.</p><p><strong>Results: </strong>Among 31,263 hospitalizations with Impella CP, 1988 (6.4%) were classified as off-label. While on-label use increased over time, off-label use remained stable. Hospitalizations with off-label Impella use represented younger patients (61.0 vs 65.6 years; p < 0.0001) who were more often female (33.7% vs 27.8%; p < 0.001) and Black (15.2% vs 12.5%; p < 0.0001) and had fewer comorbidities (Elixhauser score 4.2 vs 4.9; p < 0.0001) and more elective admissions (30.3% vs 18.6%; p < 0.0001). Hospitalizations with off-label Impella use were associated with higher in-hospital mortality (37.5% vs 27.9%, p < 0.0001), similar access site complications (15.1% vs 13.8%, p = 0.12), longer hospital LOS (median 15.8 vs 14.4 days, p < 0.001), and lower rates of discharge home (25.5% vs 31.3%, p < 0.001).</p><p><strong>Conclusions: </strong>In a large contemporary national cohort, 1 in 15 Impella CP placements occurred off-label. These hospitalizations involved younger, electively admitted patients with fewer comorbidities but were associated with higher mortality and longer LOS.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of a drug-coated balloon-only strategy for de novo ACC/AHA type B2/C coronary lesions in large vessels: A propensity-matched comparison with drug-eluting stents.","authors":"Ryo Bando, Koji Yamaguchi, Tomoya Hara, Yutaka Kawabata, Takayuki Ise, Masataka Sata","doi":"10.1016/j.carrev.2026.07.020","DOIUrl":"https://doi.org/10.1016/j.carrev.2026.07.020","url":null,"abstract":"<p><strong>Background: </strong>Drug-coated balloons (DCB) have emerged as an alternative to drug-eluting stents (DES) in selected coronary lesions; however, their role in complex percutaneous coronary intervention (PCI), particularly in large vessels, remains unclear.</p><p><strong>Objectives: </strong>This study compared clinical outcomes between a DCB-only strategy performed after successful lesion preparation and DES implantation in patients with de novo ACC/AHA type B2/C coronary lesions in large vessels.</p><p><strong>Methods: </strong>We conducted a retrospective single-center study of patients undergoing PCI for de novo complex lesions in large coronary vessels, defined as those with a reference vessel diameter ≥ 3.0 mm, between January 2018 and December 2023. Clinical outcomes were analyzed at the patient level using one predefined index lesion per patient. In the DCB group, the final decision to perform DCB-only PCI was made after successful lesion preparation, defined as TIMI grade 3 flow, residual stenosis <30%, and no major dissection. The primary endpoint was target lesion failure (TLF), defined as a composite of cardiac death, target vessel myocardial infarction, and ischemia-driven target lesion revascularization. Propensity score matching and additional Cox models stratified by matched pair were used to adjust for baseline differences and account for the matched design.</p><p><strong>Results: </strong>Among 325 patients with 325 index lesions, 123 patients were treated with DCB-only PCI and 202 patients with DES implantation. Hybrid DCB-DES PCI cases were excluded from the analysis. After propensity score matching, 113 patients in each group were analyzed. During a mean follow-up of 1344.5 ± 725.9 days, TLF occurred in 5 of 113 patients in the DCB group and 11 of 113 patients in the DES group, corresponding to estimated 3-year cumulative incidences of 6.0% and 11.3%, respectively (hazard ratio, 0.48; 95% confidence interval, 0.17-1.36; log-rank P = 0.159). In multivariable analysis, DCB treatment was not independently associated with TLF (adjusted hazard ratio, 0.41; 95% confidence interval, 0.14-1.23; P = 0.11).</p><p><strong>Conclusions: </strong>In carefully selected de novo ACC/AHA type B2/C large-vessel coronary lesions judged suitable for DCB-only PCI after successful lesion preparation, a DCB-only strategy was not associated with a significant increase in TLF compared with DES implantation. These results are hypothesis-generating and do not establish equivalence or non-inferiority.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}