Impact of adjunctive use of guide extension catheter for mid-term outcome of drug-coated balloon.

AIMS: Although drug-coated balloon (DCB) angioplasty can be an alternative therapy for in-stent restenosis and small-vessel disease, recurrent target lesion failure still accounts up to 20%. We aimed to investigate whether the adjunctive use of guide extension catheter (GEC) may enhance the efficacy of DCB.

METHODS AND RESULTS: We performed a before-and-after cohort study including patients undergoing DCB angioplasty. We treated 83 patients with 93 lesions who underwent conventional DCB angioplasty and 79 patients with 94 lesions who underwent DCB angioplasty with adjunctive use of GEC. The primary outcome, defined as composite of cardiac death, non-fatal myocardial infarction (MI) and target-vessel revascularization (TVR) at 12 months, were retrospectively evaluated. The primary outcome was significantly less frequent in the GEC group compared with that in the no-GEC group (hazard ratio [HR], 0.34; 95% confidence interval [CI], 0.13-0.76; p=0.01), driven by a lower need for TVR (HR, 0.27; 95% CI, 0.09-0.67; p=0.004). The incidence of all-cause death, cardiac death, and MI was not significantly different between the two groups.

CONCLUSIONS: In this study of patients undergoing DCB angioplasty, the adjunctive use of GEC was associated with less frequent incidence of TVR.