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Efficacy and safety of hybrid strategy in the treatment of chronic total occlusion
Received:February 03, 2023  Revised:March 14, 2023  Click here to download the full text
Citation of this paper:LIU Cheng-peng,YIN Jia-sheng,WANG Rui,CHEN Han,XU Fei,ZANG Tong-tong,YU Yue,ZHOU Chang-yi,LU Hao,GE Lei,SHEN Li,GE Jun-bo.Efficacy and safety of hybrid strategy in the treatment of chronic total occlusion[J].Chinese Journal of Clinical Medicine,2023,30(3):438-444
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Author NameAffiliationE-mail
LIU Cheng-peng Department of Cardiology, Zhongshan Hospital, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai Clinical Research Center for Interventional Medicine, Shanghai 200032, China  
YIN Jia-sheng Department of Cardiology, Zhongshan Hospital, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai Clinical Research Center for Interventional Medicine, Shanghai 200032, China  
WANG Rui Department of Cardiology, Zhongshan Hospital, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai Clinical Research Center for Interventional Medicine, Shanghai 200032, China  
CHEN Han Department of Cardiology, Zhongshan Hospital, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai Clinical Research Center for Interventional Medicine, Shanghai 200032, China  
XU Fei Department of Cardiology, Zhongshan Hospital, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai Clinical Research Center for Interventional Medicine, Shanghai 200032, China  
ZANG Tong-tong Department of Cardiology, Zhongshan Hospital, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai Clinical Research Center for Interventional Medicine, Shanghai 200032, China  
YU Yue Department of Cardiology, Zhongshan Hospital, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai Clinical Research Center for Interventional Medicine, Shanghai 200032, China  
ZHOU Chang-yi Department of Cardiology, Zhongshan Hospital, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai Clinical Research Center for Interventional Medicine, Shanghai 200032, China  
LU Hao Department of Cardiology, Zhongshan Hospital, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai Clinical Research Center for Interventional Medicine, Shanghai 200032, China  
GE Lei Department of Cardiology, Zhongshan Hospital, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai Clinical Research Center for Interventional Medicine, Shanghai 200032, China  
SHEN Li Department of Cardiology, Zhongshan Hospital, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai Clinical Research Center for Interventional Medicine, Shanghai 200032, China shen.li1@zs-hospital.sh.cn 
GE Jun-bo Department of Cardiology, Zhongshan Hospital, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai Clinical Research Center for Interventional Medicine, Shanghai 200032, China  
Abstract:Objective To explore the efficacy and safety of hybrid treatment strategy based on the combination of drug-eluting stent (DES) and drug-coated balloon (DCB) in the treatment of coronary chronic total occlusion (CTO). Methods A total of 369 patients diagnosed with CTO and treated with DES only or hybrid strategy were consecutively enrolled from Zhongshan Hospital, Fudan University from September 2021 to September 2022. The clinical characteristics, percutaneous coronary intervention (PCI) related data, parameters of quantitative coronary angiography (QCA) and quantitative flow ratio (QFR), the incidence of major adverse cardiovascular events (MACE) within one-month follow-up were compared between DES group (n=220) and hybrid strategy group (n=149). Results A total of 369 CTO lesions were included, 44.7% in left anterior descending (LAD) coronary artery and 43.1% in right coronary artery (RCA). Compared with the DES group, patients in the hybrid strategy group had less number (1.67±0.66 vs 2.00±0.81, P<0.001), shorter total length ([51.53±21.52] mm vs[58.63±26.95] mm, P=0.005) of implanted stents and higher immediate post-PCI QFR of the target vessel (0.94[0.91, 0.97] vs 0.96[0.93, 0.98], P=0.045). No MACE occurred in both groups. Conclusions In the interventional treatment of CTO lesions, compared with DES only strategy, hybrid strategy of DCB combined with DES significantly reduced stent implantation and improved functional blood supply, and does not increase the incidence of short-term MACE.
keywords:drug-eluting stent  drug-coated balloon  chronic total occlusion  quantitative flow ratio
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