Fractional flow reserve-guided paclitaxel-coated balloon treatment for de novo coronary lesions

Authors

  • Eun-Seok Shin MD, PhD,

    Corresponding author
    1. Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
    • Correspondence to: Eun-Seok Shin, MD, PhD, Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwan-doro, Dong-gu, Ulsan, 682-714, South Korea. E-mail: sesim1989@gmail.com

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  • Soe Hee Ann MD,

    1. Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
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  • Gillian Balbir Singh MBCHB, FRACP,

    1. Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
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  • Kyung Hun Lim MD,

    1. Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
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  • Franz X. Kleber MD,

    1. Cardio Centrum Berlin, Academic Teaching Institution, Charité Universitätsmedizin Berlin, Berlin, Germany
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  • Bon-Kwon Koo MD, PhD

    1. Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea
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  • Conflict of interest: Nothing to report.

Abstract

Objectives

To assess the safety and efficacy of fractional flow reserve (FFR) guided paclitaxel-coated balloon (PCB) treatment for de novo coronary artery lesions. Background: There is limited data on PCB treatment for de novo lesions especially of major epicardial coronary arteries.

Methods

Sixty-six patients with 67 de novo lesions who underwent successful plain old balloon angioplasty (POBA) were included. If POBA-FFR was favorable (≥ 0.85), PCB was applied and if POBA-FFR was <0.85, stent implantation was preferred over PCB.

Results

Forty-five lesions were treated with PCB (67.2%) and 22 lesions with stents (32.8%). Dual antiplatelet therapy duration was 6 weeks. Late luminal loss with PCB was significantly less than stent (0.05 ± 0.27 mm vs. 0.40 ± 0.54 mm, P = 0.022). The baseline FFR of target lesions was 0.69 ± 0.16 in PCB and 0.60 ± 0.11 in stent group (P = 0.015), however, the FFR at 9 months was not different between groups (0.85 ± 0.08 in PCB vs. 0.85 ± 0.05 in stent group, P = 0.973). At 1 year, one myocardial infarction and one target lesion revascularization related to in-stent restenosis were detected, both in the stent group.

Conclusion

POBA-FFR-guided PCB treatment is safe and effective for de novo coronary lesions with good anatomical and physiological patency at mid-term follow-up. © 2015 Wiley Periodicals, Inc.

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