Ludovic Meunier, Simon Eccleshall, Ronan Bakdi, Matthieu Godin, Géraud Souteyrand, Benoît Mottin, Yann Valy, Christian Benoit, Vincent Lordet, Virginie Laurençon, Antoine Milhem, Matthias Waliszewski, Caroline Allix-Béguec
{"title":"冠状动脉疾病药物包覆球囊无支架策略的长期有效性：一项前瞻性全患者观察性研究的3年随访","authors":"Ludovic Meunier, Simon Eccleshall, Ronan Bakdi, Matthieu Godin, Géraud Souteyrand, Benoît Mottin, Yann Valy, Christian Benoit, Vincent Lordet, Virginie Laurençon, Antoine Milhem, Matthias Waliszewski, Caroline Allix-Béguec","doi":"10.1002/clc.70189","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Drug-eluting stent (DES) angioplasty is the gold standard treatment for coronary lesions. Drug-coated balloon (DCB) is an option for in-stent restenosis, and has also shown promise for small-calibre coronary artery disease. We evaluated the 3-year effectiveness of a decision algorithm for percutaneous coronary intervention (PCI) that favoured a stent-less strategy (SLS) in primary angioplasty.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>All patients who underwent angioplasty during 1 year were included in a prospective observational study. Patients eligible for SLS first underwent scoring balloon followed by DCB angioplasty or DES in case of mandatory bailout. Patients not eligible for SLS were unstable patients who underwent conventional drug-eluting stenting. The metal index, stent burden, was calculated by stent length divided by the total lesion length. A 36-month follow-up recorded target lesion revascularization (TLR).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Patients eligible for SLS represented 85% (<i>n</i> = 840) of patients who underwent PCI. TLR was required in 2.6% and 6% of patients in the DCB-only and bailout-DES groups, respectively. Median metal index was 0.25 (IQR: 0.5) in patients with TLR. There was a difference between TLR–free survival distributions in the DCB-only and bailout-DES groups (<i>p</i> = 0.016).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>The SLS based on a combination of scoring balloon and DCB was effective at 3 years with a low rate of TLR. This rate was higher in patients with stent burden.</p>\n \n <p><b>Trial Registration:</b> This study was registered with clinicaltrials. gov (NCT03893396, first posted on March 28, 2019).</p>\n </section>\n </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 8","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70189","citationCount":"0","resultStr":"{\"title\":\"Long-Term Effectiveness of a Stent-Less Strategy With Drug Coated Balloon in Coronary Artery Disease: 3-Year Follow-Up of a Prospective All-Comers Observational Study\",\"authors\":\"Ludovic Meunier, Simon Eccleshall, Ronan Bakdi, Matthieu Godin, Géraud Souteyrand, Benoît Mottin, Yann Valy, Christian Benoit, Vincent Lordet, Virginie Laurençon, Antoine Milhem, Matthias Waliszewski, Caroline Allix-Béguec\",\"doi\":\"10.1002/clc.70189\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>Drug-eluting stent (DES) angioplasty is the gold standard treatment for coronary lesions. Drug-coated balloon (DCB) is an option for in-stent restenosis, and has also shown promise for small-calibre coronary artery disease. We evaluated the 3-year effectiveness of a decision algorithm for percutaneous coronary intervention (PCI) that favoured a stent-less strategy (SLS) in primary angioplasty.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>All patients who underwent angioplasty during 1 year were included in a prospective observational study. Patients eligible for SLS first underwent scoring balloon followed by DCB angioplasty or DES in case of mandatory bailout. Patients not eligible for SLS were unstable patients who underwent conventional drug-eluting stenting. The metal index, stent burden, was calculated by stent length divided by the total lesion length. A 36-month follow-up recorded target lesion revascularization (TLR).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Patients eligible for SLS represented 85% (<i>n</i> = 840) of patients who underwent PCI. TLR was required in 2.6% and 6% of patients in the DCB-only and bailout-DES groups, respectively. Median metal index was 0.25 (IQR: 0.5) in patients with TLR. There was a difference between TLR–free survival distributions in the DCB-only and bailout-DES groups (<i>p</i> = 0.016).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>The SLS based on a combination of scoring balloon and DCB was effective at 3 years with a low rate of TLR. 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Long-Term Effectiveness of a Stent-Less Strategy With Drug Coated Balloon in Coronary Artery Disease: 3-Year Follow-Up of a Prospective All-Comers Observational Study
Introduction
Drug-eluting stent (DES) angioplasty is the gold standard treatment for coronary lesions. Drug-coated balloon (DCB) is an option for in-stent restenosis, and has also shown promise for small-calibre coronary artery disease. We evaluated the 3-year effectiveness of a decision algorithm for percutaneous coronary intervention (PCI) that favoured a stent-less strategy (SLS) in primary angioplasty.
Methods
All patients who underwent angioplasty during 1 year were included in a prospective observational study. Patients eligible for SLS first underwent scoring balloon followed by DCB angioplasty or DES in case of mandatory bailout. Patients not eligible for SLS were unstable patients who underwent conventional drug-eluting stenting. The metal index, stent burden, was calculated by stent length divided by the total lesion length. A 36-month follow-up recorded target lesion revascularization (TLR).
Results
Patients eligible for SLS represented 85% (n = 840) of patients who underwent PCI. TLR was required in 2.6% and 6% of patients in the DCB-only and bailout-DES groups, respectively. Median metal index was 0.25 (IQR: 0.5) in patients with TLR. There was a difference between TLR–free survival distributions in the DCB-only and bailout-DES groups (p = 0.016).
Conclusions
The SLS based on a combination of scoring balloon and DCB was effective at 3 years with a low rate of TLR. This rate was higher in patients with stent burden.
Trial Registration: This study was registered with clinicaltrials. gov (NCT03893396, first posted on March 28, 2019).
期刊介绍：
Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery.
The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content.
The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.
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