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 (0.940.91, 0.97 vs 0.960.93, 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.
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