Drug-Coated Balloon Treatment of Unprotected De Novo Left Main Coronary Artery Disease

Abstract

Abstract Purpose The safety and efficacy of drug-coated balloon (DCB) treatment of de novo lesions in unprotected left main (LM) coronary arteries remain an unresolved issue. The aim of this study was to evaluate the outcomes of DCB-only treatment for unprotected LM coronary artery disease. Methods This retrospective registry study comprised a total of 42 consecutive patients diagnosed with unprotected de novo LM disease and stable hemodynamic conditions. A satisfactory pre-balloon angioplasty was defined as visual residual stenosis ≤ 30% without flow-limiting dissection and was followed by DCB treatment. Patients who did not meet these criteria were treated with a drug-eluting stent (DES). Results Among the cohort of 42 patients, 23 individuals received DCB-only treatment, while 19 patients were treated DES based on the results of pre-balloon angioplasty. Notably, no instances of bailout stenting or emergency coronary bypass surgery were observed following DCB treatment. Additionally, there were no reported cases of mortality or myocardial infarction within the DCB-only group during both hospitalization and the one-year follow-up period. Two patients (8.7%) experienced target lesion revascularization, all of whom presented with stable angina. A luminal increase was observed in 46.7% of cases, and the mean late lumen loss in the DCB-only treatment group was measured as 0.07 ± 0.45 mm. Conclusion DCB treatment of unprotected LM disease may be a safe and effective alternative to DES in carefully selected patients who have achieved satisfactory predilation results. (Impact of Drug-Coated Balloon Treatment in De Novo Coronary Lesion; NCT04619277)