scholarly journals A case of drug-coated balloon treatment for three-vessel stenosis with left main bifurcation lesion

2020 ◽  
Vol 27 (1) ◽  
pp. 85-86
Author(s):  
Tae-Hyun Kim ◽  
Ju-Hyun Chung ◽  
Eun-Seok Shin
Keyword(s):  
Left Main ◽  
Bifurcation Lesion ◽  
Vessel Stenosis ◽  
Drug Coated Balloon

scholarly journals Stentless Strategy by Drug-Coated Balloon Angioplasty following Directional Coronary Atherectomy for Left Main Bifurcation Lesion

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Norihiro Kobayashi ◽  
Masahiro Yamawaki ◽  
Shinsuke Mori ◽  
Masakazu Tsutsumi ◽  
Yohsuke Honda ◽  
...  
Keyword(s):  
De Novo ◽  
Artery Bypass ◽  
The Other ◽  
Bleeding Complications ◽  
Left Main ◽  
Other Hand ◽  
Bifurcation Lesion ◽  
Bifurcation Lesions ◽  
Directional Coronary Atherectomy ◽  
Drug Coated Balloon

Aims. We aimed to evaluate the efficacy of stentless strategy by drug-coated balloon (DCB) angioplasty following directional coronary atherectomy (DCA) for left main (LM) bifurcation lesions. Methods. A total of 38 patients who underwent DCB angioplasty following DCA for LM bifurcation lesions were retrospectively enrolled. The primary endpoint was target vessel failure (TVF) at 12 months. Secondary endpoints included procedure-related major events during the hospitalization, major adverse cardiac events at 12 months, ischemia-driven target lesion revascularization (TLR) at 12 months, and bleeding complications defined as the Bleeding Academic Research Consortium criteria ≥2 at 12 months. Results. Among these 38 lesions, 31 lesions were de novo LM bifurcation lesions and 7 lesions were stent edge restenosis at the left anterior descending (LAD) ostium. The mean % plaque area (%PA) after DCA was 44.0 ± 7.4%. TVF at 12 months occurred in 1 lesion (3.2%) of de novo LM bifurcation lesion and in 3 lesions (42.9%) of stent edge restenosis at the LAD ostium. All events of TVF were ischemia-driven TLR by percutaneous coronary intervention. Among 4 TLR cases, %PA after DCA was high (55.9%) in the de novo LM bifurcation lesions; on the other hand, %PA after DCA was low (42.4%, 38.7%, and 25.7% in the 3 cases) in stent edge restenosis at the LAD ostium. No procedure-related major events were observed during hospitalization. There was no cardiac death, no myocardial infarction, no coronary artery bypass grafting, and no bleeding complications at 12 months. Conclusions. Stentless strategy by DCB angioplasty following DCA for de novo LM bifurcation lesions resulted in acceptable outcomes. On the other hand, its efficacy was limited for stent edge restenosis at the LAD ostium even after aggressive debulking by DCA.

scholarly journals Vascular Response after Directional Coronary Atherectomy for Left Main Bifurcation Lesion

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Norihiro Kobayashi ◽  
Masahiro Yamawaki ◽  
Mana Hiraishi ◽  
Shinsuke Mori ◽  
Masakazu Tsutsumi ◽  
...  
Keyword(s):  
Large Vessel ◽  
Vascular Response ◽  
Left Main ◽  
Vessel Area ◽  
Plaque Area ◽  
Bifurcation Lesion ◽  
Single Center Study ◽  
Before And After ◽  
Directional Coronary Atherectomy ◽  
Drug Coated Balloon

Aims. To evaluate the vascular response after directional coronary atherectomy (DCA) for left main (LM) bifurcation lesion. Methods. This study was a retrospective, single-center study enrolling 31 patients who underwent stentless therapy using DCA followed by drug-coated balloon (DCB) angioplasty for LM bifurcation lesion. We compared intravascular ultrasound (IVUS) findings before and after DCA. Results. After DCA, the lumen and vessel areas significantly increased, whereas the plaque area (PA) and %PA were significantly reduced. When the lesions were divided into small vessel and large vessel groups using the median value of the vessel area, the maximum balloon pressure of the DCA catheter was greater in the large vessel group. Changes in the lumen and vessel areas were also significantly greater in the large vessel group. On the other hand, the changes in PA and %PA were similar between groups. Conclusions. The main vascular responses associated with lumen enlargement after DCA were plaque reduction and vessel expansion. Contribution of vessel expansion to lumen enlargement was larger than the effect of plaque reduction in large vessel lesions.

scholarly journals Vascular Response after Directional Coronary Atherectomy for Left Main Bifurcation Lesion

2021 ◽  
Author(s):  
Norihiro Kobayashi ◽  
Masahiro Yamawaki ◽  
Mana Hiraishi ◽  
Shinsuke Mori ◽  
Masakazu Tsutsumi ◽  
...  
Keyword(s):  
Small Vessel ◽  
Vascular Response ◽  
Left Main ◽  
Vascular Responses ◽  
Vessel Area ◽  
Plaque Area ◽  
Bifurcation Lesion ◽  
Single Center Study ◽  
Directional Coronary Atherectomy ◽  
Drug Coated Balloon

Abstract Purpose: To evaluate the vascular response after directional coronary atherectomy (DCA) for left main (LM) bifurcation lesion.Methods: This study was a retrospective, single-center study enrolling 31 patients who underwent stent-less therapy using DCA followed by drug-coated balloon angioplasty for LM bifurcation lesion. We compared the intravascular ultrasound (IVUS) findings pre- and post DCA. Results: After DCA, the lumen and vessel areas significantly increased whereas the plaque area (PA) and %PA significantly decreased. When the lesions were divided into small and large vessel groups using the median vessel area value, the maximum balloon pressure of the DCA catheter was greater in the large than in the small vessel group. Changes in the lumen and vessel areas were also significantly greater in the large than in the small vessel group. Conversely, the PA and %PA changes were similar between the groups. Conclusion: The main vascular responses associated with lumen enlargement after DCA were plaque reduction and vessel expansion. Contribution of vessel expansion to lumen enlargement was larger than the effect of plaque reduction in large than in small-vessel lesions.

scholarly journals TCTAP C-061 Drug-coated Balloon Usage in Left Main Bifurcation Lesion

2019 ◽  
Vol 73 (15) ◽  
pp. S131
Author(s):  
Tanveer Iqbal Penwala ◽  
Rubenthiran Navaratnam ◽  
Al Fazir Omar ◽  
Yau Piow Ng
Keyword(s):  
Left Main ◽  
Bifurcation Lesion ◽  
Drug Coated Balloon
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