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ISR vs de novo lesions treated with DCB: a four-year real-world comparative analysis
Session:
Sessão de Posters 06 - Balões revestidos na ICP contemporânea
Speaker:
José Luís Ferraro
Congress:
CPC 2026
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.2 Coronary Intervention
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
José Luís Ferraro; Ana Rodrigo Costa; Carla Almeida; Joel Ponte Monteiro; Rui Pontes Dos Santos; Inês Gomes Campos; Rafaela Gonçalves Lopes; Mauro Moreira; Aurora Andrade
Abstract
<p style="text-align:justify"><span style="font-size:12px"><span style="font-family:Arial,Helvetica,sans-serif">Background: Drug-coated balloons (DCB) are established for in-stent restenosis (ISR) but increasingly used in de novo coronary lesions. We analysed a four-year real-world DCB registry comparing these two lesion subsets.</span></span></p> <p style="text-align:justify"><span style="font-size:12px"><span style="font-family:Arial,Helvetica,sans-serif">Methods: Consecutive patients treated with DCB between 2021–2025 were included. Demographic, procedural, angiographic and clinical outcomes were compared. Key endpoints included angiographic success (<30% residual stenosis, TIMI 3 flow), recoil, need for bailout stenting and clinically driven target lesion revascularisation. </span></span></p> <p style="text-align:justify"><span style="font-size:12px"><span style="font-family:Arial,Helvetica,sans-serif">Results: A total of 150 patients were included. Patients were classified as <em>de novo lesions</em> (73%, n=109) or <em>ISR</em> (27%, n=41). Baseline demographic characteristics were similar (mean age 65.94 ± 10.37 vs. 69.34 ± 9.77 years, p = 0.364), predominantly men (p=0.490). DM and history of previous acute coronary syndrome was significantly more prevalent in the ISR group (<em>p</em> < 0.001). There were no significant differences for hypertension and dyslipidemia. Regarding clinical presentation at admission (STEMI, NSTEMI, unstable angina or CCS), there were no significant differences (p=0.452). ISR lesions were more commonly located in the RCA and LAD arteries, while <em>de novo </em>lesions showed higher involvement of the LAD and Cx, <em>p</em> = 0.012. Side-branch involvement was significantly more common in <em>de novo</em> lesions (p<0.001). Intracoronary imaging was more frequently performed in ISR (p=0.04). Angiographic performance was consistently high: angiographic success reached 97% overall, without significant differences between ISR and de novo lesions (p=0.52). Rates of recoil were infrequent and comparable across groups (p=0.41). Bailout stenting remained low in the two groups (7% vs 5%, p=0.26). TLR occurred exclusively in ISR lesions (4.9%), while no TLR events were observed in de novo lesions. The association between lesion type and TLR was statistically significant (p=0.020). No periprocedural myocardial infarction, no major bleeding and no contrast nephropathy occurred in either group. Early and mid-term safety remained excellent, with no unplanned readmissions at 6 months.</span></span></p> <p style="text-align:justify"><span style="font-size:12px"><span style="font-family:Arial,Helvetica,sans-serif">Conclusion: In this real-world DCB registry, ISR and de novo lesions demonstrated equally high procedural success and low periprocedural risk. Overall, DCB angioplasty showed strong safety and favourable angiographic outcomes across lesion subsets, however,TLR events were exclusively seen in ISR, highlighting the higher complexity of those lesions.</span></span></p>
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