BackgroundOptimal lesion preparation for coronary lesions has been reappraised in the interventional community, given the increasing use of drug‐coated balloons for de novo lesions; however, whether multiple ballooning could achieve more favorable angiographic results compared with single ballooning remains unknown. We aimed to investigate the incremental effect of multiple ballooning on de novo coronary lesions over single ballooning as assessed by optical coherence tomography (OCT) and intravascular ultrasound (IVUS) among patients undergoing percutaneous coronary intervention (PCI).MethodsPatients with chronic coronary syndrome (CCS) undergoing PCI were enrolled. Ballooning before stent implantation was repeatedly performed for three times using the same semi‐compliant balloon. OCT and IVUS were performed after each balloon dilatation. Primary outcome measure was the difference in the mean lumen area between post‐1st ballooning (1B) and post‐3rd ballooning (3B) as assessed by OCT.ResultsA total of 32 lesions in 30 patients undergoing PCI between May 2021 and August 2022 were analyzed. Major plaque types of the lesions were fibrous (68.8%) and lipid (28.1%). Mean lumen area by OCT was significantly increased from 1B to 3B (5.9 ± 2.9 mm2 vs. 6.0 ± 2.9 mm2, difference: 0.2 ± 0.4 mm2, p = 0.040). There were significant increases from 1B to 3B in minimum lumen area by OCT (3.1 ± 1.5 mm2 vs. 3.6 ± 1.7 mm2, difference: 0.5 ± 0.6 mm2, p < 0.001) and mean dissection angle by OCT (65.6 ± 24.9° vs. 95.2 ± 34.0°, difference: 29.6 ± 25.5°, p < 0.001). Additionally, mean plaque area by IVUS was significantly decreased (8.0 ± 4.2 mm2 vs. 7.8 ± 4.1 mm2, difference: −0.2 ± 0.2 mm2, p < 0.001).ConclusionsAmong CCS patients with mainly non‐calcified lesions, multiple ballooning significantly increased the lumen area and dissection angle compared with single ballooning.

中文翻译：

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通过光学相干断层扫描和血管内超声评估多次气球扩张对冠状动脉病变的影响


背景鉴于越来越多地使用药物涂层球囊治疗新发病变，冠状动脉病变的最佳病变准备已在介入界重新评估。然而，与单次球囊扩张相比，多次球囊扩张是否能获得更有利的血管造影结果仍不清楚。我们的目的是通过光学相干断层扫描 (OCT) 和血管内超声 (IVUS) 评估接受经皮冠状动脉介入治疗 (PCI) 的患者，研究多次球囊扩张相对于单次球囊扩张对新发冠状动脉病变的增量影响。方法慢性冠状动脉综合征 (CCS) 患者）接受 PCI 的患者被纳入。使用相同的半顺应性球囊重复进行3次支架植入前的球囊扩张。每次球囊扩张后均进行 OCT 和 IVUS。主要结局指标是通过 OCT 评估的第一次球囊扩张后 (1B) 和第三次球囊扩张后 (3B) 之间的平均管腔面积差异。 结果分析了 2021 年 5 月至 2022 年 8 月期间接受 PCI 的 30 名患者的总共 32 个病变。病变斑块类型主要为纤维斑块（68.8%）和脂质斑块（28.1%）。 OCT 平均管腔面积从 1B 到 3B 显着增加（5.9 ± 2.9 mm2 与 6.0 ± 2.9 mm2，差异：0.2 ± 0.4 mm2，p = 0.040）。从 1B 到 3B，OCT 的最小管腔面积显着增加（3.1 ± 1.5 mm2 与 3.6 ± 1.7 mm2，差异：0.5 ± 0.6 mm2，p < 0.001），OCT 的平均夹层角度（65.6 ± 24.9° vs. 95.2 ± 34.0°，差异：29.6 ± 25.5°，p < 0.001）。此外，IVUS 的平均斑块面积显着减少（8.0 ± 4.2 mm2 与 7.8 ± 4.1 mm2，差异：-0.2 ± 0.2 mm2，p < 0.001）。结论在以非钙化病变为主的CCS患者中，与单次球囊扩张相比，多次球囊扩张显着增加了管腔面积和夹层角度。