Long-term efficacy of drug coated balloons compared with new generation drug-eluting stents for the treatment of de novo coronary artery lesions

Dimitrios Venetsanos, Sofia Sederholm Lawesson, Georgios Panayi, Tim Tödt, Ulf Berglund, Eva Swahn, Joakim Alfredsson

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19 Citations (SciVal)

Abstract

© 2018 Wiley Periodicals, Inc. Background: Studies comparing drug coated balloons (DCB) with new generation drug-eluting stents (nDES) for the treatment of de novo coronary artery lesions are lacking. Methods: From 2009 to 2016, DCB or nDES used for treatment of de novo coronary lesions at our institution were included, in total 1,197 DEB and 6,458 nDES. We evaluated target lesions restenosis (TLR) and definite target lesion thrombosis (TLT). Propensity score modeling were utilized to study adjusted associations between treatment and outcomes. Results: Median follow-up was 901days. DCB patients were older, with higher cardiovascular risk profile. Bailout stenting after DCB was performed in 8% of lesions. The cumulative rate of TLR and TLT was 7.0 vs. 4.9% and 0.2 vs. 0.8% for DCB vs. nDES, respectively. Before adjustment, DCB was associated with a higher risk of TLR [hazard ratio (HR) 1.44; 95% confidence interval (CI) 1.07-1.94] and a non-significantly lower risk of TLT (HR 0.30; 95% CI 0.07-1.24), compared to nDES. In the propensity matched population consisted of 1,197 DCB and 1,197 nDES, treatment with DCB was associated with similar risk for TLR (adjusted HR 1.05; 95% CI 0.72-1.53) but significantly lower risk for TLT (adjusted HR 0.18; 95% CI 0.04-0.82) compared to nDES. Conclusions: Treatment with DCB was associated with a similar risk of TLR and a lower risk of definite TLT compared with nDES. In selected cases, DCB appears as a good alternative to nDES for the treatment of de novo coronary lesions.
Original languageEnglish
Pages (from-to)E317-E326
JournalCatheterization and Cardiovascular Interventions
Volume92
Issue number5
Early online date2018 Jan 1
DOIs
Publication statusPublished - 2018

Subject classification (UKÄ)

  • Cardiac and Cardiovascular Systems

Keywords

  • De novo lesions
  • Drug-coated balloon
  • Drug-eluting balloon
  • Restenosis
  • Stent thrombosis

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