药物涂层球囊治疗冠心病患者静脉桥血管原位病变的效果观察

Outcomes of drug-coated balloon versus drug-eluting stent in the de novo lesions of saphenous vein grafts

目的:探讨药物涂层球囊(DCB)治疗冠心病患者静脉桥血管(SVG)原位病变的有效性和安全性。方法:回顾性连续纳入2018年1月—2020年12月在接受DCB或药物洗脱支架(DES)治疗冠状动脉旁路移植(CABG)术后SVG原位病变的冠心病患者,分为DCB组和DES组。分析两组的基线和病变特征,主要终点是靶病变再狭窄,次要终点是靶病变血运重建(TLR)和不良心血管事件(MACE),后者包括靶病变再狭窄、心源性死亡、急性心肌梗死以及靶血管血运重建(TVR)。结果:本研究共纳入54例患者,其中DCB组31例(33处病变),DES组23例(24处病变)。两组的基线、病变特征均无统计学差异。DCB组中位随访时间为17.0个月,DES组中位随访时间20.0个月(P>0.05)。结果显示,DCB组与DES组的靶病变再狭窄发生率无统计学差异(12.9%vs 21.7%,log-rank P=0.470),两组的TLR及MACE事件发生率也相似(TLR:12.9%vs 4.3%,log-rank P=0.168;MACE:16.1%vs 26.1%,log-rank P=0.663)。结论:同DES相比,DCB在冠心病患者SVG原位病变中的应用是有效、安全的。

Objective:This study aims to explore the outcomes of the drug-coated balloon(DCB)in the de novo lesions of saphenous vein grafts(SVG).Methods:This observational study analyzed the patients treated with DCB or drug-eluting stent(DES)in SVG de novo lesions from January 2018 to December 2020.Restenosis was the primary endpoint,and target lesion revascularization(TLR)and major adverse cardiac events(MACE),including all examples of restenosis,cardiac death,target vessel revascularization,and myocardial infarction as the secondary outcomes.Results:We enrolled 31 patients with DCB and 23 with DES(57 lesions in total).Baseline clinical data,lesion characteristics,and procedural characteristics were all similar between the two groups.The rate of restenosis was 12.9%versus 21.7%(log-rank P=0.470)between DCB and DES group.No significant differences were observed in the rates of MACE(16.1%vs 26.1%,log-rank P=0.663)and TLR(12.9%vs 4.3%,log-rank P=0.168)during the clinical follow-up.Conclusion:DCB is efficient and safe in treating SVG de novo lesions compared with new-generation DES.