The following is a summary of “Coronary Artery Dissection in Drug-Coated Balloon Angioplasty: Incidence, Predictors, and Clinical Outcomes,” published in the December 2024 issue of Cardiology by Gitto et al.
Coronary artery dissection is a potential complication during percutaneous coronary intervention (PCI). Drug-coated balloons (DCBs) do not cover dissections, which requires evaluating the safety in such cases.
Researchers conducted a retrospective study to evaluate coronary artery dissections’ incidence, predictors, and clinical outcomes in people undergoing DCB angioplasty.
They enrolled consecutive people with de novo coronary artery disease (CAD) undergoing PCI with DCB angioplasty with or without stent implantation (2018 and 2022) at 2 Italian centers. The decision to manage dissections with or without bail-out stenting was based on angiographic evaluation, which included factors such as Thrombolysis in Myocardial Infarction (TIMI) flow, minimal lumen diameter, and persistent contrast hang-up (P<0.001).
The results showed that coronary artery dissections occurred in 39.1% of 522 DCB-treated lesions in 466 people, with 21.1% requiring bail-out stenting and 78.9% left untreated. Involvement of the left anterior descending artery (OR 1.64, 95% CI: 1.12-2.39) was the strongest predictor of dissection. At a 2-year follow-up, target lesion failure (TLF) occurred in 2.7% of lesions with untreated dissection compared to 4.2% in those without dissection (log-rank P=0.324).
They concluded that coronary dissections during DCB angioplasty do not increase AEs at mid-term follow-ups when left untreated.
Source: ajconline.org/article/S0002-9149(24)00850-6/abstract