| Objective:To compare the efficacy and safety of drug-coated balloon and second generation drug-eluting stent in the treatment of coronary chronic total occlusion.Methods:Retrospective selection of patients admitted to the First Hospital of Shanxi Medical University for percutaneous coronary intervention(PCI)treatment from March 2019 to January 2022.According to the inclusion and exclusion criteria,88 patients were selected for inclusion in the group.According to the interventional treatment method,they were divided into drug coated balloon DCB group(36 cases)and drug eluting stent DES group(52 cases).Baseline clinical data of patients were collected,including gender,age,current medical history,past history,laboratory results,and echocardiography.Surgical data: intraoperative and postoperative coronary angiography results,and follow-up coronary angiography results at 12 months after surgery.The clinical study endpoint was major adverse cardiovascular events(MACE)at 12 months after surgery in both groups,including target vessel revascularization(TVR),nonfatal myocardial infarction,cardiogenic death.Results:(1)There was no statistically significant difference in the general baseline clinical data between the two groups of patients(P>0.05);There was no significant difference in preoperative coronary angiography related data between the two groups(P>0.05);(2)The immediate postoperative lumen diameter in the DCB group was smaller than that in the DES group(2.18 ± 0.24 vs 2.52 ± 0.27 mm,P<0.01),and the degree of lumen stenosis was [24.80(21.12,27.79)% vs.13.80(12.59,15.21)%,P<0.001];(3)At 12 months after surgery,the late lumen loss of the target vessel in the DCB group was smaller than that in the DES group [-0.08(-0.18,0.06)mm vs 0.28(0.08,0.52)mm,P<0.01],and the minimum lumen diameter MLD of the two groups was(2.12± 0.56)vs(2.05 ± 0.69)mm,P=0.605;The degree of lumen stenosis in the two groups was [21.94(16.44,26.63)% vs 25.46(16.11,32.69)%,P=0.283];There were 6 cases(16.7%)of restenosis in the DCB group and 10 cases(19.2%)of restenosis in the DES group.There was no statistically significant difference in the rate of restenosis between the two groups(P=0.759);(4)At 12 months after surgery,LVEF in DCB group increased compared to preoperative(54.72 ± 12.38 vs 59.44 ± 9.42,P<0.05),LVEDD decreased compared to preoperative(51.08 ± 6.66 vs 49.25 ± 5.53,P<0.05),and LVFS increased compared to preoperative(29.19 ± 7.56 vs 32.07 ± 5.69,P<0.05),with a statistically significant difference;In DES group,LVEF improved(53.79 ± 10.95 vs 56.63 ± 9.55,P<0.05),LVFS increased(30.90 ± 9.02 vs 33.49 ± 7.16,P<0.05),and LVEDD decreased(53.33 ±6.36 vs 50.13 ± 5.89,P<0.05)compared to preoperative,with statistically significant differences;There was no statistically significant difference in LVEF,LVEDD,and LVFS between the DCB group and the DES group before surgery and at 12 months after surgery(P>0.05);(5)At 12 months,There was 1 case(2.7%)of reocclusion in the DCB group,and a total of 3 patients(8.3%)underwent target vessel revascularization TVR.There were 3cases(5.8%)of reocclusion in the DES group,and a total of 8 patients(15.4%)underwent TVR.Neither group experienced cardiac death or nonfatal myocardial infarction,there was no significant difference in the incidence of MACE between the two groups(P=0.512);Survival analysis showed that there was no significant difference in the survival rate without MACE between the two groups(P>0.05),and the Kaplan-Meier survival curve showed that there was no significant difference in the survival rate between the two groups at 12 months after surgery(Log bank,X~2= 0.844,P=0.358).Conclusion:Drug coated balloons are safe and effective in treating chronic total occlusion of coronary arteries.Compared to drug eluting stents,drug-coated balloons are more effective in reducing late lumen loss and the clinical prognosis is comparable to that of drug-eluting stents. |
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