Acute and Late Angiographic Lumen Assessment of the Coronary Artery Diameter After Drug Coated Balloon Angioplasty

Background Drug‐coated balloon (DCB) angioplasty has emerged as an alternative strategy. However, data on its mid‐term angiographic and clinical outcomes remain limited. Methods This study included 70 patients who underwent DCB angioplasty. Quantitative coronary angiography (QCA) measurements were obtained before, immediately after, and at follow‐up angiography. The primary endpoint was binary restenosis (≥ 50% diameter stenosis), while secondary endpoints included late lumen loss (LLL), late lumen enlargement (LLE), and target lesion revascularization (TLR). Aims We aimed to evaluate angiographic outcomes of DCB‐treated de novo, in‐stent restenosis (ISR), and chronic total occlusion (CTO) lesions using follow‐up coronary angiography and quantitative coronary angiography (QCA), including acute lumen gain, late lumen loss, late lumen gain, and binary restenosis. Results Among 70 patients, 25 (35.7%) developed binary restenosis at follow‐up. Minimal lumen diameter, minimal lumen area, and percent diameter stenosis showed significant differences across pre‐procedure, post‐procedure, and follow‐up assessments (all p < 0.001). LLL was observed in 72.9% of patients, whereas 27.1% exhibited LLE. Multivariate logistic regression identified active smoking as an independent predictor of binary restenosis (odds ratio [OR]: 9.23, p = 0.019), whereas female sex was associated with a lower risk (OR: 0.07, p = 0.031). No acute thrombosis occurred within 48 h, and one noncardiac death was reported during the first month. Conclusion DCB angioplasty demonstrated favorable mid‐term angiographic efficacy with low rates of binary restenosis and TLR. These findings support DCB therapy as an effective revascularization strategy for selected patients with coronary artery disease.