Instantaneous wave-free ratio-guided paclitaxel-coated balloon treatment for de novo coronary lesions

Paclitaxel-coated balloon (PCB) treatment guided by fractional flow reserve (FFR) is safe and effective for de novo coronary lesions. It is unknown whether the instantaneous wave-free ratio (iFR), an alternative measure that does not require the administration of adenosine, will offer benefits simil...

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Veröffentlicht in:INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2020-02, Vol.36 (2), p.179-185
Hauptverfasser: Chung, Ju-Hyun, Shin, Eun-Seok, Her, Ae-Young, Lee, Joo Myung, Doh, Joon-Hyung, Nam, Chang-Wook, Koo, Bon-Kwon
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container_issue 2
container_start_page 179
container_title INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING
container_volume 36
creator Chung, Ju-Hyun
Shin, Eun-Seok
Her, Ae-Young
Lee, Joo Myung
Doh, Joon-Hyung
Nam, Chang-Wook
Koo, Bon-Kwon
description Paclitaxel-coated balloon (PCB) treatment guided by fractional flow reserve (FFR) is safe and effective for de novo coronary lesions. It is unknown whether the instantaneous wave-free ratio (iFR), an alternative measure that does not require the administration of adenosine, will offer benefits similar to those of FFR in de novo lesion treatment with PCB. Baseline, post-balloon and 9-month angiographical parameters were obtained from 116 lesions of 104 patients. The cutoff value of iFR after balloon angioplasty used to define functionally nonsignificant residual stenotic lesions was 0.86 and they were subdivided into PCB or Stent group according to the treated device. The primary endpoint was late lumen loss at 9 months and the secondary endpoint was target vessel failure (TVF) at 3 years. Fifty-eight lesions were treated with PCB only and 58 lesions were treated with metal stent implantation. There were no differences in iFR between PCB and Stent groups at baseline (0.76 ± 0.19 vs. 0.73 ± 0.23, p = 0.630) and after procedure (0.93 ± 0.04 vs. 0.94 ± 0.05, p = 0.574). At 9 months, late lumen loss was significantly lower in PCB group compared with Stent group (0.04 ± 0.32 mm vs. 0.59 ± 0.77 mm, p = 0.001). At 3-year follow-up, TVF were not different between the treatment groups (5.2% vs. 8.6%, p = 0.453). PCB treatment guided by iFR measured right after balloon angioplasty is safe and effective for de novo coronary lesions with good angiographic results at 9 months and similar clinical outcomes at 3 years compared to stent group.
doi_str_mv 10.1007/s10554-019-01707-5
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It is unknown whether the instantaneous wave-free ratio (iFR), an alternative measure that does not require the administration of adenosine, will offer benefits similar to those of FFR in de novo lesion treatment with PCB. Baseline, post-balloon and 9-month angiographical parameters were obtained from 116 lesions of 104 patients. The cutoff value of iFR after balloon angioplasty used to define functionally nonsignificant residual stenotic lesions was 0.86 and they were subdivided into PCB or Stent group according to the treated device. The primary endpoint was late lumen loss at 9 months and the secondary endpoint was target vessel failure (TVF) at 3 years. Fifty-eight lesions were treated with PCB only and 58 lesions were treated with metal stent implantation. There were no differences in iFR between PCB and Stent groups at baseline (0.76 ± 0.19 vs. 0.73 ± 0.23, p = 0.630) and after procedure (0.93 ± 0.04 vs. 0.94 ± 0.05, p = 0.574). At 9 months, late lumen loss was significantly lower in PCB group compared with Stent group (0.04 ± 0.32 mm vs. 0.59 ± 0.77 mm, p = 0.001). At 3-year follow-up, TVF were not different between the treatment groups (5.2% vs. 8.6%, p = 0.453). PCB treatment guided by iFR measured right after balloon angioplasty is safe and effective for de novo coronary lesions with good angiographic results at 9 months and similar clinical outcomes at 3 years compared to stent group.</description><identifier>ISSN: 1569-5794</identifier><identifier>EISSN: 1573-0743</identifier><identifier>EISSN: 1875-8312</identifier><identifier>DOI: 10.1007/s10554-019-01707-5</identifier><identifier>PMID: 31598811</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject><![CDATA[Adenosine ; Aged ; Angioplasty ; Angioplasty, Balloon, Coronary - adverse effects ; Angioplasty, Balloon, Coronary - instrumentation ; Balloon treatment ; Blood vessels ; Cardiac & Cardiovascular Systems ; Cardiac Catheterization ; Cardiac Catheters ; Cardiac Imaging ; Cardiology ; Cardiovascular Agents - administration & dosage ; Cardiovascular Agents - adverse effects ; Cardiovascular System & Cardiology ; Coated Materials, Biocompatible ; Coronary Angiography ; Coronary Artery Disease - diagnosis ; Coronary Artery Disease - physiopathology ; Coronary Artery Disease - therapy ; Coronary Restenosis - diagnostic imaging ; Coronary Restenosis - etiology ; Coronary Stenosis - diagnosis ; Coronary Stenosis - physiopathology ; Coronary Stenosis - therapy ; Equipment Design ; Female ; Fractional Flow Reserve, Myocardial ; Humans ; Imaging ; Implantation ; Implants ; Lesions ; Life Sciences & Biomedicine ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Paper ; Paclitaxel ; Paclitaxel - administration & dosage ; Paclitaxel - adverse effects ; PCB ; PCB compounds ; Polychlorinated biphenyls ; Predictive Value of Tests ; Radiology ; Radiology, Nuclear Medicine & Medical Imaging ; Registries ; Science & Technology ; Severity of Illness Index ; Stents ; Surgical implants ; Time Factors ; Treatment Outcome]]></subject><ispartof>INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, 2020-02, Vol.36 (2), p.179-185</ispartof><rights>Springer Nature B.V. 2019</rights><rights>The International Journal of Cardiovascular Imaging is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>6</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000513217200002</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c375t-bad01641fd678601bdd52c0fb75b9ff339b3117759f326a388a46f77d40769ce3</citedby><cites>FETCH-LOGICAL-c375t-bad01641fd678601bdd52c0fb75b9ff339b3117759f326a388a46f77d40769ce3</cites><orcidid>0000-0002-9169-6968</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10554-019-01707-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10554-019-01707-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,28253,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31598811$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chung, Ju-Hyun</creatorcontrib><creatorcontrib>Shin, Eun-Seok</creatorcontrib><creatorcontrib>Her, Ae-Young</creatorcontrib><creatorcontrib>Lee, Joo Myung</creatorcontrib><creatorcontrib>Doh, Joon-Hyung</creatorcontrib><creatorcontrib>Nam, Chang-Wook</creatorcontrib><creatorcontrib>Koo, Bon-Kwon</creatorcontrib><title>Instantaneous wave-free ratio-guided paclitaxel-coated balloon treatment for de novo coronary lesions</title><title>INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING</title><addtitle>Int J Cardiovasc Imaging</addtitle><addtitle>INT J CARDIOVAS IMAG</addtitle><addtitle>Int J Cardiovasc Imaging</addtitle><description>Paclitaxel-coated balloon (PCB) treatment guided by fractional flow reserve (FFR) is safe and effective for de novo coronary lesions. It is unknown whether the instantaneous wave-free ratio (iFR), an alternative measure that does not require the administration of adenosine, will offer benefits similar to those of FFR in de novo lesion treatment with PCB. Baseline, post-balloon and 9-month angiographical parameters were obtained from 116 lesions of 104 patients. The cutoff value of iFR after balloon angioplasty used to define functionally nonsignificant residual stenotic lesions was 0.86 and they were subdivided into PCB or Stent group according to the treated device. The primary endpoint was late lumen loss at 9 months and the secondary endpoint was target vessel failure (TVF) at 3 years. Fifty-eight lesions were treated with PCB only and 58 lesions were treated with metal stent implantation. There were no differences in iFR between PCB and Stent groups at baseline (0.76 ± 0.19 vs. 0.73 ± 0.23, p = 0.630) and after procedure (0.93 ± 0.04 vs. 0.94 ± 0.05, p = 0.574). At 9 months, late lumen loss was significantly lower in PCB group compared with Stent group (0.04 ± 0.32 mm vs. 0.59 ± 0.77 mm, p = 0.001). At 3-year follow-up, TVF were not different between the treatment groups (5.2% vs. 8.6%, p = 0.453). PCB treatment guided by iFR measured right after balloon angioplasty is safe and effective for de novo coronary lesions with good angiographic results at 9 months and similar clinical outcomes at 3 years compared to stent group.</description><subject>Adenosine</subject><subject>Aged</subject><subject>Angioplasty</subject><subject>Angioplasty, Balloon, Coronary - adverse effects</subject><subject>Angioplasty, Balloon, Coronary - instrumentation</subject><subject>Balloon treatment</subject><subject>Blood vessels</subject><subject>Cardiac &amp; Cardiovascular Systems</subject><subject>Cardiac Catheterization</subject><subject>Cardiac Catheters</subject><subject>Cardiac Imaging</subject><subject>Cardiology</subject><subject>Cardiovascular Agents - administration &amp; dosage</subject><subject>Cardiovascular Agents - adverse effects</subject><subject>Cardiovascular System &amp; Cardiology</subject><subject>Coated Materials, Biocompatible</subject><subject>Coronary Angiography</subject><subject>Coronary Artery Disease - diagnosis</subject><subject>Coronary Artery Disease - physiopathology</subject><subject>Coronary Artery Disease - therapy</subject><subject>Coronary Restenosis - diagnostic imaging</subject><subject>Coronary Restenosis - etiology</subject><subject>Coronary Stenosis - diagnosis</subject><subject>Coronary Stenosis - physiopathology</subject><subject>Coronary Stenosis - therapy</subject><subject>Equipment Design</subject><subject>Female</subject><subject>Fractional Flow Reserve, Myocardial</subject><subject>Humans</subject><subject>Imaging</subject><subject>Implantation</subject><subject>Implants</subject><subject>Lesions</subject><subject>Life Sciences &amp; Biomedicine</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Middle Aged</subject><subject>Original Paper</subject><subject>Paclitaxel</subject><subject>Paclitaxel - administration &amp; dosage</subject><subject>Paclitaxel - adverse effects</subject><subject>PCB</subject><subject>PCB compounds</subject><subject>Polychlorinated biphenyls</subject><subject>Predictive Value of Tests</subject><subject>Radiology</subject><subject>Radiology, Nuclear Medicine &amp; Medical Imaging</subject><subject>Registries</subject><subject>Science &amp; Technology</subject><subject>Severity of Illness Index</subject><subject>Stents</subject><subject>Surgical implants</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>1569-5794</issn><issn>1573-0743</issn><issn>1875-8312</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkV2L1TAQhoMo7of-AS-k4I2wRGeSpmkv5eDHwoI3eh3SdLJ06UmOSbqr_94cu67ghQgJCeF5h5k8jL1AeIMA-m1GUKrlgEPdGjRXj9gpKi056FY-Pt67gSs9tCfsLOcbABAg5FN2IlENfY94yugy5GJDXRTX3NzZW-I-ETXJljny63WeaGoO1i1zsd9p4S7aUl9GuywxhqYksmVPoTQ-pmaiJsTb2LiYYrDpR7NQnmPIz9gTb5dMz-_Pc_b1w_svu0_86vPHy927K-6kVoWPdgLsWvRTp_sOcJwmJRz4Uatx8F7KYZSIWqvBS9FZ2fe27bzWUwu6GxzJc_Z6q3tI8dtKuZj9nB0tyzaeERKkbpUSWNFXf6E3cU2hdlcp1XYoAUWlxEa5FHNO5M0hzfs6mUEwRwlmk2CqBPNLglE19PK-9DruaXqI_P71ClxswB2N0Wc3U3D0gFVNCqVALeBorNL9_9O7qqmKC7u4hlKjcovmiodrSn-G_Ef_PwEDVbMG</recordid><startdate>20200201</startdate><enddate>20200201</enddate><creator>Chung, Ju-Hyun</creator><creator>Shin, Eun-Seok</creator><creator>Her, Ae-Young</creator><creator>Lee, Joo Myung</creator><creator>Doh, Joon-Hyung</creator><creator>Nam, Chang-Wook</creator><creator>Koo, Bon-Kwon</creator><general>Springer Netherlands</general><general>Springer Nature</general><general>Springer Nature B.V</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9169-6968</orcidid></search><sort><creationdate>20200201</creationdate><title>Instantaneous wave-free ratio-guided paclitaxel-coated balloon treatment for de novo coronary lesions</title><author>Chung, Ju-Hyun ; Shin, Eun-Seok ; Her, Ae-Young ; Lee, Joo Myung ; Doh, Joon-Hyung ; Nam, Chang-Wook ; Koo, Bon-Kwon</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-bad01641fd678601bdd52c0fb75b9ff339b3117759f326a388a46f77d40769ce3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adenosine</topic><topic>Aged</topic><topic>Angioplasty</topic><topic>Angioplasty, Balloon, Coronary - adverse effects</topic><topic>Angioplasty, Balloon, Coronary - instrumentation</topic><topic>Balloon treatment</topic><topic>Blood vessels</topic><topic>Cardiac &amp; Cardiovascular Systems</topic><topic>Cardiac Catheterization</topic><topic>Cardiac Catheters</topic><topic>Cardiac Imaging</topic><topic>Cardiology</topic><topic>Cardiovascular Agents - administration &amp; dosage</topic><topic>Cardiovascular Agents - adverse effects</topic><topic>Cardiovascular System &amp; Cardiology</topic><topic>Coated Materials, Biocompatible</topic><topic>Coronary Angiography</topic><topic>Coronary Artery Disease - diagnosis</topic><topic>Coronary Artery Disease - physiopathology</topic><topic>Coronary Artery Disease - therapy</topic><topic>Coronary Restenosis - diagnostic imaging</topic><topic>Coronary Restenosis - etiology</topic><topic>Coronary Stenosis - diagnosis</topic><topic>Coronary Stenosis - physiopathology</topic><topic>Coronary Stenosis - therapy</topic><topic>Equipment Design</topic><topic>Female</topic><topic>Fractional Flow Reserve, Myocardial</topic><topic>Humans</topic><topic>Imaging</topic><topic>Implantation</topic><topic>Implants</topic><topic>Lesions</topic><topic>Life Sciences &amp; 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It is unknown whether the instantaneous wave-free ratio (iFR), an alternative measure that does not require the administration of adenosine, will offer benefits similar to those of FFR in de novo lesion treatment with PCB. Baseline, post-balloon and 9-month angiographical parameters were obtained from 116 lesions of 104 patients. The cutoff value of iFR after balloon angioplasty used to define functionally nonsignificant residual stenotic lesions was 0.86 and they were subdivided into PCB or Stent group according to the treated device. The primary endpoint was late lumen loss at 9 months and the secondary endpoint was target vessel failure (TVF) at 3 years. Fifty-eight lesions were treated with PCB only and 58 lesions were treated with metal stent implantation. There were no differences in iFR between PCB and Stent groups at baseline (0.76 ± 0.19 vs. 0.73 ± 0.23, p = 0.630) and after procedure (0.93 ± 0.04 vs. 0.94 ± 0.05, p = 0.574). At 9 months, late lumen loss was significantly lower in PCB group compared with Stent group (0.04 ± 0.32 mm vs. 0.59 ± 0.77 mm, p = 0.001). At 3-year follow-up, TVF were not different between the treatment groups (5.2% vs. 8.6%, p = 0.453). PCB treatment guided by iFR measured right after balloon angioplasty is safe and effective for de novo coronary lesions with good angiographic results at 9 months and similar clinical outcomes at 3 years compared to stent group.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>31598811</pmid><doi>10.1007/s10554-019-01707-5</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-9169-6968</orcidid></addata></record>
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subjects Adenosine
Aged
Angioplasty
Angioplasty, Balloon, Coronary - adverse effects
Angioplasty, Balloon, Coronary - instrumentation
Balloon treatment
Blood vessels
Cardiac & Cardiovascular Systems
Cardiac Catheterization
Cardiac Catheters
Cardiac Imaging
Cardiology
Cardiovascular Agents - administration & dosage
Cardiovascular Agents - adverse effects
Cardiovascular System & Cardiology
Coated Materials, Biocompatible
Coronary Angiography
Coronary Artery Disease - diagnosis
Coronary Artery Disease - physiopathology
Coronary Artery Disease - therapy
Coronary Restenosis - diagnostic imaging
Coronary Restenosis - etiology
Coronary Stenosis - diagnosis
Coronary Stenosis - physiopathology
Coronary Stenosis - therapy
Equipment Design
Female
Fractional Flow Reserve, Myocardial
Humans
Imaging
Implantation
Implants
Lesions
Life Sciences & Biomedicine
Male
Medicine
Medicine & Public Health
Middle Aged
Original Paper
Paclitaxel
Paclitaxel - administration & dosage
Paclitaxel - adverse effects
PCB
PCB compounds
Polychlorinated biphenyls
Predictive Value of Tests
Radiology
Radiology, Nuclear Medicine & Medical Imaging
Registries
Science & Technology
Severity of Illness Index
Stents
Surgical implants
Time Factors
Treatment Outcome
title Instantaneous wave-free ratio-guided paclitaxel-coated balloon treatment for de novo coronary lesions
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