Favorable Vasomotor Function after Drug-Coated Balloon-Only Angioplasty of De Novo Native Coronary Artery Lesions
- Authors
- Kim, Sunwon; Lee, Jong-Seok; Kim, Yong-Hyun; Kim, Jin-Seok; Lim, Sang-Yup; Kim, Seong Hwan; Kim, Minjung; Ahn, Jeong-Cheon; Song, Woo-Hyuk
- Issue Date
- 1월-2022
- Publisher
- MDPI
- Keywords
- drug-coated balloon; de novo lesion; vasospasm; coronary vasomotor function
- Citation
- JOURNAL OF CLINICAL MEDICINE, v.11, no.2
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF CLINICAL MEDICINE
- Volume
- 11
- Number
- 2
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/138949
- DOI
- 10.3390/jcm11020299
- ISSN
- 2077-0383
- Abstract
- 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.
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Collections - College of Medicine > Department of Medical Science > 1. Journal Articles
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