Comparison of the efficacy of drug-coated balloon angioplasty and drug-eluting stent implantation in the treatment of chronic total coronary artery occlusion
Objective To compare the clinical efficacy of drug-coated balloon(DCB)angioplasty with that of drug-eluting stent implantation(DES)for the treatment of chronic total occlusive lesions(CTO)in coronary arteries.Methods A total of 89 patients with CT confirmed by coronary angiography at the Department of Cardiovascular Medicine of the Northern Theater General Hospital between December 2020 and December 2021 and were treated successfully were enrolled continuously as study subjects.The follow-up period was 1 year.The patients were divided into two groups:DCB group(n=32)and DES group(n=57)based on the 2021 DCB Asia-Pacific expert consensus.The main observation endpoint was target vessel revascularization(TVR)at the 1-year follow-up.Secondary endpoints included quantitative coronary angiography(QCA)findings,minimum lumen diameter(MLD),mean vessel diameter(MVD),reference diameter(RFD),and late lumen enlargement(LLE)of target vessels.Safety endpoints included immediate procedural safety,incidence of major adverse cardiovascular events(MACE),and increase rate in bleeding grade according to Bleeding Academic Research Consortium(BARC).Results The average follow-up time was(12±3)months,and the incidence of TVR was 12.50％and 10.53％in the two groups one year after surgery,respectively,and there was no significant difference between the two groups(P＞0.05);the incidence of MACE was 12.50％and 12.28％,respectively,and the increase rates of BRAC bleeding grade were 12.50％and 14.04％,respectively,with no significant difference(P＞0.05).There was no significant difference in MLD,MVD or RFD between the two groups(P＞0.05),while the LLE of the two groups was 0.13(0,0.57)mm and-0.03(-0.22,0)mm,respectively,and the difference was statistically significant(P＜0.05).Conclusion The application of DCB in CTO lesions was not inferior to that of DES in CTO lesions,and the long-term lumen diameter increase of DCB was significantly greater than that of DES alone in CTO lesions with sufficient pre-expansion but without severe dissection hematoma.
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