Dissection healing process after drug-coated balloon treatment for de novo coronary lesions assessed with early optical coherence tomography follow-up

Background Drug-coated balloons (DCBs) are currently used for de novo coronary artery lesions. However, the natural course of the dissection after percutaneous coronary intervention (PCI) at an early stage remains unclear. Aims We sought to examine post-PCI dissection healing in de novo coronary lesions treated with DCBs by serial optical coherence tomography (OCT) imaging. Methods Of 94 de novo coronary lesions treated with DCB, OCT imaging at the pre-, post-PCI, and early follow-up period (< 12 months) were performed, and morphological findings, including residual dissection, were assessed. Results The median follow-up period was 231 (interquartile range, 112–314) days (< 3 months; 16 lesions [17.0%], 3–6 months; 23 lesions [24.5%]), and 84.0% of post-PCI dissection was not observed at follow-up. In persistent dissection lesions, more diabetes patients (66.7% vs. 29.1%, P = 0.008), more dual antiplatelet therapy continuation at follow-up (80.0% vs. 46.8%, P = 0.024), and shorter follow-up duration (median 44 days vs 258 days, P < 0.001) were found than in non-persistent dissection lesions. Residual dissection was significantly more common in lesions <3 months post-follow-up, compared to those with 3–6 months and 6–12 months (68.8% vs 8.7% vs 3.6%, P < 0.001). Conclusion The present study suggests that residual dissection was substantially less frequent beyond 3 months, suggesting progressive healing during the first several months after DCB treatment.