Early occlusion after drug-coated balloon therapy for de novo lesions: A case series with intracoronary imaging insights
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Background As ‘leaving nothing behind’ strategy in percutaneous coronary interventions, drug-coated balloons (DCBs) for de novo coronary lesions are attracting increasing attention for their potential to avoid complications such as stent thrombosis and the need for prolonged antiplatelet therapy. Case presentation We present three cases of early occlusions following DCB therapies for de novo left anterior descending artery lesions, accompanied by intracoronary imaging findings. The most important common cause of the early occlusions was insufficient lesion preparation. Because all the lesions were in vessels with diffuse plaques, undersized predilatation balloons was selected based on the lumen diameter at the diseased distal reference site (predilatation balloon/vessel diameter ratios: 0.68, 0.66, 0.68). It is noteworthy that residual stenosis in these three cases remained below 30%, with no evidence of flow-limiting dissection at the index procedures. Conclusion This case series underscores the features of cases that developed early occlusions after drug-coated balloon therapy for de novo coronary lesions.
