Vol. 26 No. 4 (2022)
Endovascular Surgery

Long-term outcomes of drug-eluting balloons for treatment of side branches in patients with true coronary bifurcation lesions

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  • T.K. Eraliev,
  • D.A. Khelimskii,
  • A.G. Badoian,
  • O.V. Krestyaninov,
  • A.A. Baranov,
  • A.P. Gorgulko
T.K. Eraliev
Cardio Asia Plus Medical Center
D.A. Khelimskii
Meshalkin National Medical Research Center
Bio
A.G. Badoian
Meshalkin National Medical Research Center
O.V. Krestyaninov
Meshalkin National Medical Research Center
A.A. Baranov
Meshalkin National Medical Research Center
A.P. Gorgulko
Meshalkin National Medical Research Center
Клинический статус пациентов через 12 месяцев после чрескожного коронарного вмешательства
DOI: https://doi.org/10.21688/1681-3472-2022-4-7-18

Published 2022-12-29

Keywords

  • Drug-Eluting Stents,
  • Coronary Artery Disease,
  • Paclitaxel,
  • Percutaneous Coronary Intervention

How to Cite

Eraliev, T. ., Khelimskii, D., Badoian, A., Krestyaninov, O., Baranov, A., & Gorgulko, A. (2022). Long-term outcomes of drug-eluting balloons for treatment of side branches in patients with true coronary bifurcation lesions. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 26(4), 7–18. https://doi.org/10.21688/1681-3472-2022-4-7-18

Copyright (c) 2022 Eraliev T.K., Khelimskii D.A., Badoian A.G., Krestyaninov O.V., Baranov A.A., Gorgulko A.P.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Background: Bifurcation treatments make up ca. 15–20% of coronary interventions. Despite the use of drug-eluting stents, the management of bifurcation lesions, especially with side branches involved, remains a challenge.
Objective: To evaluate long-term clinical and angiographic outcomes after using a paclitaxel-coated balloon for the treatment of side branches in patients with true bifurcation lesions.
Methods: Eighty patients with coronary artery disease were enrolled after true bifurcation lesion stenting. All patients were randomized at the 1:1 ratio to the group of main branches stenting followed by the dilatation of side branches with drug-eluting balloons and provisional stenting group.
Results: Long-term results were analyzed after 12 months. The most common bifurcation lesion involved the left anterior descending artery and diagonal branch (57.5%). Late lumen loss in the side branch (0.51 ± 0.22 vs 0.33 ± 0.24 mm) and in both the bifurcation branches (main branch + side branch) (1.06 ± 0.29 vs 0.79 ± 0.27 mm) was significantly higher in the patients after provisional stenting.
Overall postoperative incidence of major adverse cardiovascular events was 17.5% and 7.5% (p = 0.31) in the provisional stenting and drug coated balloon groups, respectively. Patients with drug-eluting balloons for the treatment of side branches had a more pronounced decrease in angina symptoms after 12 months. Multivariate analysis showed that diabetes mellitus (OR: 10.9) and glomerular filtration rate (OR: 0.95) were independent predictors of major adverse cardiovascular events in bifurcation interventions.
Conclusion: Drug-eluting balloons for the dilatation of side branches after the stenting of main branches are superior to provisional stenting in terms of the late lumen loss.

Received 31 August 2022. Revised 17 November 2022. Accepted 18 November 2022.

Funding: The study did not have sponsorship.

Conflict of interest: The authors declare no conflict of interest.

Contribution of the authors
Conception and study design: T.K. Eraliev, D.A. Khelimskii, A.G. Badoian, O.V. Krestyaninov
Data collection and analysis: T.K. Eraliev, D.A. Khelimskii, A.G. Badoian, O.V. Krestyaninov, A.A. Baranov, A.P. Gorgulko
Statistical analysis: T.K. Eraliev, D.A. Khelimskii, A.G. Badoian
Drafting the article: T.K. Eraliev, D.A. Khelimskii, A.G. Badoian, O.V. Krestyaninov, A.A. Baranov, A.P. Gorgulko
Critical revision of the article: T.K. Eraliev, D.A. Khelimskii, A.G. Badoian, O.V. Krestyaninov
Final approval of the version to be published: T.K. Eraliev, D.A. Khelimskii, A.G. Badoian, O.V. Krestyaninov,
A.A. Baranov, A.P. Gorgulko

pdf (Русский)

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