Effect of Drug-Coated Balloons in  Native  XXXX Left  With a Dissection.

@entity1 @entity453 @entity1373 @entity75
OBJECTIVES: The authors sought to understand the clinical and angiographic outcomes of dissections left after drug-coated balloon (DCB) angioplasty. BACKGROUND: Second-generation DCB may be an alternative to stents in selected populations for the treatment of native coronary lesions. However, the use of these devices may be hampered by a certain risk of acute vessel recoil or residual coronary dissection. Moreover, stenting after DCB has shown limited efficacy. Little is known about when a non-flow-limiting dissection is left after DCB angioplasty. METHODS: This was a prospective observational study whose aim was to investigate the outcome of a consecutive series of @entity1 with native @entity453 treated with second-generation DCB and residual coronary dissection at 2 Italian centers. We evaluated @entity1 clinical conditions at 1 and 9 months, and angiographic follow up was undertaken at 6 months. RESULTS: Between July 2012 and July 2014, 156 @entity1 were treated with DCB for native @entity453 . Fifty-two @entity1 had a final dissection, 4 of which underwent prosthesis implantation and 48 were left untreated and underwent angiographic follow-up after 201 days (interquartile range 161 to 250 days). The dissections were all type A to C, and none determined an impaired distal flow. Complete vessel healing at angiography was observed in 45 @entity1 (93.8%), whereas 3 @entity1 had persistent but uncomplicated dissections, and 3 had binary restenosis (6.2%). Late lumen loss was 0.14 mm (-0.14 to 0.42). Major adverse cardiovascular events occurred in 11 @entity1 in the entire cohort and in 4 of the dissection cohort (7.2% vs. 8.1%; p  = 0.48). We observed 8 and 3 @entity75 revascularizations, respectively (5.3% vs. 6.2%; p  = 0.37). CONCLUSIONS: In this cohort of consecutive @entity1 treated with new-generation DCB and left with a final dissection, this strategy of revascularization seemed associated with the sealing of most of dissections and without significant neointimal @entity1373 .
