Combined use of drug-coated balloon (DCB) and cutting balloon angioplasty (CBA) in the treatment of acute coronary syndrome

Purpose: To determine the effectiveness and safety of combined use of drug-coated balloon (DCB) and cutting balloon angioplasty (CBA) in patients with acute coronary syndrome (ACS). Methods: One hundred and fifty-six patients with ACS undergoing DCB or CBA from January 2019 to January 2021 served as subjects in this study. There were 30 in-stent re-stenosis (ISR) patients in group A, 31 ISR patients in group B, 61 de novo patients in group C, and 34 de novo patients in group D. Baseline characteristics, high-risk factors, biochemical indices, incidence of intervention-related complications, and major adverse cardiovascular events (MACE) were compared amongst the groups, before and after operation. Results: Group B had a higher immediate minimum lumen diameter (MLD) after operation than group A, and group D had higher immediate MLD after operation than group C. Group B produced higher acute gain after intervention than group A, but post-intervention acute gain was greater in group D than in group C. There were significant differences in late luminal loss (LLL) amongst the groups (p = 0.013), but LLL was comparable in groups A and B (p = 0.411), and in groups C and D (p = 0.434). During the follow-up period, the incidence of MACE in group A was significantly greater than in group B, but MACE in group C was comparable to that in group D. Conclusion: Combined treatment with CBA and DCB significantly improves postoperative immediate MLD and acute gain after intervention in patients with ISR lesions or de novo lesions, without reducing long-term effectiveness and safety. Multi-center trials involving larger number of patients will be required to validate the results from this study.