[MO-36] Presentation Awards
Larger balloons are recommended for lesion preparation before using drug-coated balloons: intravascular ultrasound analysis
Background: Drug-coated balloons (DCBs) are indicated after successful plain balloon angioplasty. Ideal balloon size for lesion preparation is not well investigated. Objectives: This study evaluated impact of balloon size for lesion preparation (prep-size) before using DCBs. Methods: We retrospectively assigned thirty-five consecutive procedures to two groups according to whether the prep-size were smaller than (group S: n = 24) or equal to (group E: n = 11) the final DCB size. All balloon sizes were decided from intra-vascular ultrasound (IVUS) measurement and by operators' discretion. Serial IVUS analysis was performed and minimum lumen area (MLA) was measured. IVUS-documented dissections were graded according to its depth (A: intimal, and B: medial) and its angular width (1: 0-90 degrees, 2: 90-180 degrees, 3: 180-360 degrees). Primary endpoint of the study was escalation in dissection grades between pre- and post- DCB treatment. Results: There was no significant difference in MLA after final DCB treatment (group S: 11.80+/-3.84 vs group E: 13.36 +/- 5.34mm2, p=0.334). Cross-sectional area was larger in group E after lesion preparation but not statistically significant (group S: 8.20+/-3.12 vs group E: 10.21 +/- 3.80mm2, p=0.109). Escalation of dissection grade was significantly popular (8/24 vs 0/11, p=0.037) in group S. Conclusions: Up-sizing the balloon diameter after lesion preparation may result in escalated dissections. Balloon size for lesion preparation is recommennded to be the same as the planned final DCB.