Scoring balloon versus drug-eluting balloon in coronary intervention for very small coronary vessels

Y. Metwally, K. Elnady
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Abstract

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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记分球囊与药物洗脱球囊在小冠状动脉介入治疗中的应用
背景:对非常小的冠状动脉血管(<2.5 mm)进行冠脉介入治疗的最佳治疗策略仍然存在争议和挑战。目的:本研究的目的是评估评分球囊(SB)与药物洗脱球囊(DEB)在非常小(<2.5 mm)冠状动脉介入治疗中的12个月结果。患者和方法:77例参考血管直径<2.5 mm行冠状动脉介入治疗的患者被分配到SB或DEB组。主要终点是12个月随访时的靶血管重建术(TVR)。结果:在77例入组患者中,37.7%的患者被分配到SB, 62.3%的患者被分配到DEB。DEB组严重夹层率显著高于对照组(0% vs. 12.5%, P = 0.048);而SB组TVR率明显低于对照组(0% vs. 12.5%, P = 0.048)。同样,SB组靶血管相关心肌梗死发生率明显降低(0% vs. 12.5%, P = 0.048)。另一方面,两组之间的死亡率和再狭窄率没有显著差异。结论与建议:SB优于DEB,在细小冠状动脉(<2.5 mm)介入治疗中具有更好的安全性和有效性。需要更大规模的前瞻性多中心随机试验来证实我们在<2.5 mm的非常小的冠状血管中使用SB进行冠状动脉介入治疗的有利结果。
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