scholarly journals Favorable Vasomotor Function after Drug-Coated Balloon-Only Angioplasty of De Novo Native Coronary Artery Lesions

2022 ◽  
Vol 11 (2) ◽  
pp. 299
Author(s):  
Sunwon Kim ◽  
Jong-Seok Lee ◽  
Yong-Hyun Kim ◽  
Jin-Seok Kim ◽  
Sang-Yup Lim ◽  
...  
Keyword(s):  
Coronary Artery ◽  
De Novo ◽  
Provocation Test ◽  
Vasospastic Angina ◽  
Coronary Artery Lesions ◽  
Native Coronary Artery ◽  
Vasomotor Function ◽  
Coronary Lesions ◽  
Drug Coated Balloon

Balloon-injured coronary segments are known to harbor abnormal vasomotion. We evaluated whether de novo coronary lesions treated using drug-coated balloon (DCB) are prone to vasospasm and how they respond to ergonovine and nitrate. Among 132 DCB angioplasty recipients followed, 89 patients underwent ergonovine provocation test at 6–9 months follow-up. Within-subject ergonovine- and nitrate-induced diameter changes were compared among three different sites: DCB-treated vs. angiographically normal vs. segment showing prominent vasoreactivity (spastic). No patient experienced clinically refractory vasospastic angina or symptom-driven revascularization during follow-up. Ergonovine induced vasospasm in seven patients; all were multifocal spasm either involving (n = 2) or rather sparing DCB-treated segments (n = 5). None showed focal spasm that exclusively involved DCB-treated lesions. Among 27 patients with vasospastic features, DCB-treated segments showed less vasoconstriction than spastic counterparts (p < 0.001). A total of 110 DCB-treated lesions were analyzed to assess vasomotor function. Vasomotor function, defined as a combined constrictor and dilator response, was comparable between DCB-treated and angiographically normal segments (p = 0.173), while significant differences were observed against spastic counterparts (p < 0.001). In our study, DCB-treated lesions were not particularly vulnerable to vasospasm and were found to have vasomotor function similar to angiographically normal segments, supporting safety of DCB-only strategy in treating de novo native coronary lesions.

One year clinical follow-up of the XIENCE V Everolimus-eluting stent system in the treatment of patients with de novo native coronary artery lesions: the SPIRIT II study

2007 ◽  
Vol 3 (3) ◽  
pp. 315-320 ◽  
Author(s):  
Peter Ruygrok ◽  
Martin Desaga ◽  
Franck Van Den Branden ◽  
Klaus Rasmussen ◽  
Harry Suryapranata ◽  
...  
Keyword(s):  
Coronary Artery ◽  
De Novo ◽  
Coronary Artery Lesions ◽  
Native Coronary Artery ◽  
Stent System ◽  
One Year

Abstract 2771: Comparison of Everolimus-Eluting Stents with Paclitaxel-Eluting Stents in De Novo Native Coronary Artery Lesions: Intravascular Ultrasound Results From the SPIRIT III Trial

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Masao Yamasaki ◽  
Ichizo Tsujino ◽  
Ryota Sakurai ◽  
Katsuhisa Waseda ◽  
Takao Hasegawa ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Intravascular Ultrasound ◽  
De Novo ◽  
Volume Index ◽  
Chromium Alloy ◽  
Lumen Area ◽  
Coronary Artery Lesions ◽  
Post Intervention ◽  
Native Coronary Artery

Background : SPIRIT III is a pivotal, multicenter, 2:1 randomized, controlled trial comparing Everolimus-eluting cobalt-chromium alloy XIENCE™ V stents (EES) to Paclitaxel-eluting Taxus ™ stents (PES) in de novo native coronary artery lesions. Intravascular ultrasound (IVUS) was performed in a subset of Spirit III to further investigate the safety and efficacy profiles of EES. Methods : The SPIRIT III IVUS study enrolled 305 patients who received 359 stents (244 EES in 205 patients; 115 PES in 100 patients). Serial IVUS imaging was performed post-intervention and at 8 months follow-up. Late lumen area loss was calculated as minimum lumen area (MLA) at post-intervention minus MLA at follow-up. Volume index, defined as volume data divided by stent length, was obtained for vessel (VVI), stent (SVI), lumen (LVI), plaque (PVI), and neointima (NVI). Results : At baseline, the incidence of tissue prolapse, edge dissections, and incomplete stent apposition (ISA) were not significantly different between EES and PES (15.6 vs 19.7%, 1.3 vs 2.8%, and 31.8 vs 28.2%, respectively). At follow-up, edge dissections and late-acquired ISA were not significantly different between EES and PES (1.4 vs 3.1%, 1.7 vs 4.1%, respectively). EES showed significantly less neointimal hyperplasia and a trend toward larger follow-up lumen than PES (Table ), whereas no statistical interactions were observed between EES and serial changes for VVI and PVI. PES showed a significant increase in VVI and PVI between post-intervention and follow-up. Reference segment analysis showed no unfavorable edge effect adjacent to either EES or PES. Conclusion : Detailed IVUS analysis confirmed significantly greater neointimal suppression with EES, with no apparent adverse vessel response, as compared to PES. Additional drug-eluting stent trials in more complex lesions are warranted to further validate the clinical utility of these new technologies.

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