Predictors of bail-out stenting in patients with small vessel disease treated with drug-coated balloon percutaneous coronary intervention.
Catheter Cardiovasc Interv
; 102(1): 18-24, 2023 07.
Article
em En
| MEDLINE
| ID: mdl-37172212
ABSTRACT
BACKGROUND:
Drug-coated balloons (DCBs) have shown comparable results with drug-eluting stents in small vessel disease (SVD) percutaneous coronary intervention (PCI) in terms of target vessel revascularization and a reduced incidence of myocardial infarction. However, the relatively high rate of bail-out stenting (BOS) still represents a major drawback of DCB PCI.AIMS:
The aim of the study was to investigate the clinical, anatomic, and procedural features predictive of BOS after DCB PCI in SVD.METHODS:
We included all consecutive patients undergoing PCI at our institution between January 2020 and May 2022 who were treated with DCB PCI of a de novo lesion in a coronary vessel with a reference vessel diameter (RVD) between 2.0 and 2.5 mm. Angiographic success was defined as a residual stenosis <30% without flow-limiting dissection. Patients who did not meet these criteria underwent BOS.RESULTS:
A total of 168 consecutive patients and 216 coronary stenoses were included. The rate of bail-out stent was 13.9%. On multivariate analysis, DCB/RVD ratio (odds ratio [OR] 4.39, 95% confidence interval [CI] 1.71-11.29, p < 0.01), vessel tortuosity (OR 7.00, 95% CI 1.66-29.62, p < 0.01), distal vessel disease (OR 5.66, 95% CI 2.02-15.83, p < 0.01), and high complexity (Grade C of ACC/AHA classification) coronary stenoses (OR 6.31, 95% CI 1.53-26.04, p = 0.01) were independent predictors of BOS.CONCLUSIONS:
BOS is not an infrequent occurrence in DCB PCI of small vessels and is correlated with vessel tortuosity, distal diffuse vessel disease, higher lesion complexity, and balloon diameter oversizing.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Doenças Vasculares
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Doença da Artéria Coronariana
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Angioplastia Coronária com Balão
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Estenose Coronária
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Reestenose Coronária
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Intervenção Coronária Percutânea
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article