Drug-coated balloon-treated coronary lesions demonstrated vasomotor function comparable to angiographically normal segments (p=0.173) and were not exclusively prone to focal vasospasm.
Cohort (n=132)
Does drug-coated balloon-only angioplasty preserve vasomotor function compared to angiographically normal segments in patients with de novo native coronary artery lesions?
DCB-treated de novo coronary lesions are not particularly vulnerable to vasospasm and maintain vasomotor function similar to normal segments, supporting the safety of a DCB-only strategy.
p-value: p=0.173
Balloon-injured coronary segments are known to harbor abnormal vasomotion. We evaluated whether de novo coronary lesions treated using drug-coated balloon (DCB) are prone to vasospasm and how they respond to ergonovine and nitrate. Among 132 DCB angioplasty recipients followed, 89 patients underwent ergonovine provocation test at 6–9 months follow-up. Within-subject ergonovine- and nitrate-induced diameter changes were compared among three different sites: DCB-treated vs. angiographically normal vs. segment showing prominent vasoreactivity (spastic). No patient experienced clinically refractory vasospastic angina or symptom-driven revascularization during follow-up. Ergonovine induced vasospasm in seven patients; all were multifocal spasm either involving (n = 2) or rather sparing DCB-treated segments (n = 5). None showed focal spasm that exclusively involved DCB-treated lesions. Among 27 patients with vasospastic features, DCB-treated segments showed less vasoconstriction than spastic counterparts (p < 0.001). A total of 110 DCB-treated lesions were analyzed to assess vasomotor function. Vasomotor function, defined as a combined constrictor and dilator response, was comparable between DCB-treated and angiographically normal segments (p = 0.173), while significant differences were observed against spastic counterparts (p < 0.001). In our study, DCB-treated lesions were not particularly vulnerable to vasospasm and were found to have vasomotor function similar to angiographically normal segments, supporting safety of DCB-only strategy in treating de novo native coronary lesions.
Kim et al. (Fri,) conducted a cohort in De novo native coronary artery lesions (n=132). Drug-coated balloon (DCB) angioplasty vs. Angiographically normal segments and spastic segments was evaluated on Vasomotor function (combined constrictor and dilator response) (p=0.173). Drug-coated balloon-treated coronary lesions demonstrated vasomotor function comparable to angiographically normal segments (p=0.173) and were not exclusively prone to focal vasospasm.