Serial Morphological and Functional Assessment of the Paclitaxel-coated Balloon for de Novo Lesions.
OBJECTIVE
There is limited data on the serial morphological and functional assessment of paclitaxel-coated balloon treatment using coronary angiography, optical coherence tomography, and fractional flow reserve.


METHODS
In this prospective, single-center observational study, patients with de novo lesions were treated with the paclitaxel-coated balloon. Serial angiographic, optical coherence tomography and fractional flow reserve measurements were performed before and after plain old balloon angioplasty, as well as at 9-month follow-up.


RESULTS
Twenty patients (21 lesions) were enrolled in this study. The reference vessel diameter was 2.68±0.34mm and late luminal loss was 0.01±0.21mm. The median changes in the minimal lumen area between pre- and postplain old balloon angioplasty, and postplain old balloon angioplasty and follow-up were an increase of 75.2% [interquartile range of 37.2 to 164.7] and 50.0% [interquartile range of 1.1% to 64.5%], respectively. Intimal dissections were seen in all postprocedural optical coherence tomography images, and 66.6% of them were sealed on follow-up optical coherence tomography (median 278 days). The fractional flow reserve distal to the target lesion was 0.71±0.14 predilatation, 0.87±0.04 postdilatation, and 0.83±0.08 at follow-up.


CONCLUSIONS
The paclitaxel-coated balloon restores coronary blood flow by means of plaque modification, causing an increment in minimal lumen area. At 9-month follow-up, coronary flow was sustained and the luminal patency was the result of suppressed luminal narrowing progression from local drug effects on the de novo coronary lesions.
Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Soe Hee
SH
Ann
Division of Cardiology, Department of Internal Medicine, Kangwon National University, Chuncheon, Korea.
Ae-Young
AY
Her
Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Gillian Balbir
GB
Singh
Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan.
Takayuki
T
Okamura
Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea.
Bon-Kwon
BK
Koo
Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. Electronic address: sesim1989@gmail.com.
Eun-Seok
ES
Shin
D000368:Aged; D000787:Angina Pectoris / Q000209:etiology / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation* / Q000379:methods; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D017023:Coronary Angiography; D023903:Coronary Restenosis; D023921:Coronary Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000627:therapeutic use*; D011446:Prospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome
D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel
Balón recubierto de paclitaxel; De novo coronary lesion; Fractional flow reserve; Lesión coronaria de novo; Optical coherence tomography; Paclitaxel-coated balloon; Reserva fraccional de flujo; Respuesta vascular; Tomografía de coherencia óptica; Vascular response