Angiographic patterns after drug-coated balloon angioplasty for de novo coronary lesions.

Background: Drug-coated balloon (DCB) angioplasty has emerged as an effective treatment option for de novo coronary artery lesions; however, the chronic-phase angiographic patterns after DCB angioplasty for de novo lesions have not yet been described.

Aims: The aim of the present study was to evaluate chronic-phase angiographic classification after DCB angioplasty.

Methods: This was a single-centre, retrospective, observational study. From June 2016 to August 2022, 708 lesions (670 patients) underwent DCB angioplasty for de novo coronary lesions. Successful DCB angioplasty was defined as a non-flow-limiting dissection, with residual stenosis ≤30% and absence of a bailout stent. A total of 337 lesions (318 patients) were enrolled in this study.

Results: Of the 337 lesions analysed, 91.1% (n=307) were in the non-restenosis group, and 8.9% (n=30) were in the restenosis group. The non-restenosis group was classified into non-restenosis (45.1%; n=152) and lumen enlargement (46.0%; n=155). The restenosis group was classified into focal restenosis (5.0%; n=17), diffuse restenosis (3.6%; n=12), and occlusive restenosis (0.3%; n=1). There were no aneurysms, and plaque cavities were often observed (8.0%). During the chronic phase, residual dissection was seen in only one case (0.3%).

Conclusions: This report demonstrates for the first time the angiographic classification after DCB angioplasty for de novo coronary lesions. Restenosis patterns were seen in 8.9% of lesions, and half of the restenosis patterns presented a focal restenosis pattern. Late lumen enlargement was observed in 46% of the treated lesions.