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21 Drug coated balloon-only angioplasty in left main stem disease, a uk single centre experience
  1. Upul Wickramarachchi,
  2. Natasha H Corballis,
  3. Clint A Maart,
  4. Timothy J Gilbert,
  5. Simon C Eccleshall
  1. Department of Cardiology, Norfolk and Norwich University Hospital NHS Foundation Trust


Aims Left Main Stem (LMS) percutaneous coronary intervention (PCI) with stents have similar mortality outcomes compared to coronary artery bypass graft surgery, but with a greater risk of repeat revascularisation and potentially fatal stent thrombosis. We report medium term outcomes of drug coated balloon (DCB)-only angioplasty, a novel strategy with no permanent metallic, temporary polymer or scaffold implant.

Methods and Results 24 consecutive patients underwent DCB-only angioplasty for LMS disease from 19/07/2011 to 19/05/2016 at our centre. Clinical outcomes were obtained from the clinic follow up letters and up-to-date mortality data from the Demographic Batch Service Bureau of the Health and Social Care Information Centre. Mean (SD) age of the cohort was 68.0 (11.5) years and 19 (79.2%) were male. 10 (41.7%) patients had previous PCI. 16 (66.7%) patients had unprotected LMS disease and 19 (79.2%) were de novo lesions. 19 (79.2%) were distal bifurcation lesions and mean (SD) syntax score of the unprotected LMS group was 26.4 (12.2). During a mean (SD) follow up of 674.6 (521.7) days there were no cardiac deaths. No target lesion revascularisations, target vessel revascularisations or cerebrovascular accidents reported for a mean (SD) clinic follow up period of 367.6 (331.0) days. 1 (4.2%) patient had a myocardial infarction (MI) unrelated to the previously treated segment. No bail-out stenting, acute vessel closure or treated lesion thrombosis.

Conclusion DCB-only angioplasty to LMS disease appears to be a safe and effective treatment at medium-term follow up.

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