Application Of Paclitaxel-coated Balloon In The Protection Of Side Branch In Coronary Artery Bifurcation Lesions

Background: Coronary bifurcation stenosis account for 15-20% of percutaneous tre-ated lesions and have always been associated with higher risk of restenosis and hi-gher complication rates. Several large randomized trials showed that main branch stenting along with provisional side branch stenting has evolved as the method of choice in the majority of patients. Drug-coated balloon is an antiproliferative drug delivery system, which can release locally a controlled dose of paclitaxel to the entire injured vessel wall during balloon inflation. Considering these issues, the drug-coated balloon may be advantageous, compared to plain old balloon, in partic-ular for the treatment of the side branch. Given that, we set out to explore the fe-asibility and efficacy of drug-coated balloons in the protection of side branch in c-oronary artery bifurcation lesions.Objective:To access the feasibility and efficacy of paclitaxel-coated balloon in the protection of side branch in coronary artery bifurcation lesions.Methods:This prospective study enrolled 60 eligible patients with coronary artery bifurcation lesions(Medinal,1,1;1,0,1;0,1,1) confirmed by CAG in the cardiology cath lab of PLA general hospital from 2015-01 to 2016-05. The patients were randomly divided into two groups:the PEB group (n=29) and the POB group (n=31). Angiographic follow-up was performed immediately and then at ninth month. Clinical follow-up was conducted up to 12 months.The primary end points was late lumen loss(LLL) and restenosis rates of the side branch.The secondry end points was the composite outcome of major adverse cardiovascular events(MACE) rate .Results:One patient in the PEB group was bailed out for dissection (type C, NHLBI) after pre-dilation of the side branch. The dissection rate was higher in the PEB group than that in the POB group (27.6% VS. 6.5%, P=0.042) during the PCI procedure. The MLD in side branch measured by QCA immediately after PCI was (1.67±0.42)mm in the PEB group and (1.51 ±0.31)mm in the POB group separately(P=0.033). The late lumen loss in the side branch,measured by QCA at ninth month after PCI,was (0.05±0.11 )mm in the PEB group and (0.24 ±0.59)mm in the POB group (P=0.008) . The composite end point of MACE rate in PEB group was lower than that in POB group with no significance(10.3% vs.25.8%, P=0.187).Conclusion:Drug-coated balloon is feasible and effective in the protection of side branch in coronary artery bifurcation lesions for it brings negligible LLL and improves the quality of patients'life.