Serial assessment of de novo coronary lesions after drug-coated balloon treatment analyzed by intravascular ultrasound: A comparison between acute coronary syndrome and stable angina pectoris

Background: This study aimed to assess the serial changes in de novo coronary lesions, including acute coronary syndrome (ACS), treated with a drug-coated balloon (DCB).

Methods: In this retrospective single-center study, the intravascular changes in patients with de novo lesions treated with DCB were evaluated with serial intravascular ultrasound (IVUS) pre-procedure, post-procedure, and at follow-up. A two-dimensional IVUS measurement was performed with slices at 1 mm intervals in the treated lesion.

Results: This study comprised 40 lesions, including 27 lesions with stable angina pectoris (SAP) and 13 ACS. IVUS showed that the median vessel and lumen area increased significantly from pre-procedure to post-procedure and from post-procedure to follow-up. The median plaque area decreased significantly from pre-procedure to post-procedure and follow-up. The IVUS between ACS and SAP demonstrated that the total vessel volume and the total lumen volume increased, and the total atheroma volume decreased significantly from pre- to follow-up in both groups. The percent change in the lumen area increased, and the plaque area decreased significantly in ACS compared to SAP from pre- to post-procedure and follow-up.

Conclusion: The findings of this study suggest that DCB treatment for de novo coronary lesions in patients with ACS and SAP may maintain anatomical patency and increase lumen with positive vessel remodeling and regression of plaque.