Key result
Scoring balloon linked to 0% one-year TVR versus drug-eluting balloon.
Why the study?
The optimal therapeutic strategy for coronary intervention in very small coronary vessels (<2.5 mm.) remains controversial and challenging.
Does scoring balloon reduce target vessel revascularization compared to drug-eluting balloon in patients undergoing coronary intervention for very small coronary vessels (<2.5 mm)?
Cohort (n=77)
No
Does scoring balloon reduce target vessel revascularization compared to drug-eluting balloon in patients undergoing coronary intervention for very small coronary vessels (<2.5 mm)?
Scoring balloon may offer better safety and efficacy than drug-eluting balloon for coronary interventions in very small vessels (<2.5 mm), significantly reducing target vessel revascularization and severe dissection rates.
May support scoring balloon evaluation in very small vessels; leaves open need for randomized confirmation before practice change.
Background: The optimal therapeutic strategy for coronary intervention in very small coronary vessels (<2.5 mm.) remains controversial and challenging. Objective: The aim of this study is to assess the 12 months outcome of scoring balloon (SB) versus drug-eluting balloon (DEB) in very small (<2.5 mm) coronary interventions. Patients and Methods: Seventy-seven patients referred for coronary intervention with reference vessel diameter <2.5 mm were assigned to either SB or DEB. The primary endpoint was target vessel revascularization (TVR) at 12 months follow-up. Results: Out of 77 patients enrolled, 37.7% were assigned to SB, while 62.3% were assigned to DEB. Sever dissection rate was significantly higher among the DEB group (0% vs. 12.5%, P = 0.048); while TVR rate was significantly lower among the SB group (0% vs. 12.5%, P = 0.048). Similarly, the target vessel-related myocardial infarction rate was significantly lower among the SB group (0% vs. 12.5%, P = 0.048). On the other hand, there were no significant differences in the rates of deaths or restenosis between the two groups. Conclusion and Recommendations: SB is superior to the DEB with better both safety and efficacy for coronary intervention in very small coronary vessels (<2.5 mm). Larger scaled prospective multicenter randomized trials are needed for confirming our favorable results of using SB for coronary intervention in very small coronary vessels <2.5 mm.
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Metwally et al. (2021) conducted a cohort in Coronary artery disease requiring intervention in very small vessels (n=77). Scoring balloon vs. Drug-eluting balloon was evaluated on Target vessel revascularization (TVR) at 12 months follow-up (p=0.048). Scoring balloon was associated with a significantly lower rate of target vessel revascularization at 12 months compared to drug-eluting balloon (0% vs 12.5%, P=0.048).
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