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<p>This study evaluated the serial anatomical and morphological changes in de novo coronary lesions treated with a drug-coated balloon (DCB) using integrated-backscatter intravascular ultrasound (IB-IVUS). The aim of this study was to investigate coronary vessel behaviors following balloon angioplasty using DCB. A total of 46 de novo coronary artery lesions treated with IVUS-guided DCB were studied. Each patient underwent coronary angiography and IVUS imaging before/after the intervention, and this was repeated at 8-month follow-up. Quantitative IVUS measurements included the external elastic membrane (EEM), lumen, and plaque plus media (P + M) cross-sectional area (CSA). Plaque composition was classified as lipid pool, fibrosis, dense fibrosis, and calcification using IB-IVUS. The average length and diameter of DCB were 18.7 ± 5.0 and 2.6 ± 0.4&#xa0;mm, respectively. Acute lumen gain correlated better with vessel dilatation than plaque reduction. Overall mean EEM, P + M, and lumen CSA did not change significantly during follow-up. The Δlumen CSA was negatively correlated with the ΔP + M CSA (<i>r</i>=-0.66, <i>p</i> &lt; 0.001) and positively correlated with ΔEEM CSA (<i>r</i> = 0.52, <i>p</i> &lt; 0.001). By IB-IVUS, ΔP + M CSA correlated positively with both Δfibrosis area and Δlipid pool area. Late lumen gain (Δ lumen CSA &gt; 0) was documented in 30 lesions (65%). Lesions with late lumen gain showed a greater increase in EEM CSA (<i>P</i> = 0.006) and a greater decrease in P + M CSA (<i>P</i> = 0.007), respectively. In conclusion, de novo coronary lesions treated with DCB demonstrated lumen patency with preserved P + M and EEM CSA. A combination of arterial remodeling and plaque changes affected lumen changes during follow-up.</p> Graphical Abstract <p></p>

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Arterial remodeling and plaque changes after balloon angioplasty for de novo coronary lesions using DCB

  • 期刊论文

  • 发表日期：

    2026年6月18日

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  • Shelby Kerr,
  • Shingo Minatoguchi,
  • Allison O. Dumitriu Carcoana,
  • Chisato Kobayashi,
  • Sho Kosokabe,
  • Noriko Endo,
  • Yuto Masuda,
  • Takatomo Watanabe,
  • Hiromitsu Kanamori,
  • Hiroyuki Okura

摘要

This study evaluated the serial anatomical and morphological changes in de novo coronary lesions treated with a drug-coated balloon (DCB) using integrated-backscatter intravascular ultrasound (IB-IVUS). The aim of this study was to investigate coronary vessel behaviors following balloon angioplasty using DCB. A total of 46 de novo coronary artery lesions treated with IVUS-guided DCB were studied. Each patient underwent coronary angiography and IVUS imaging before/after the intervention, and this was repeated at 8-month follow-up. Quantitative IVUS measurements included the external elastic membrane (EEM), lumen, and plaque plus media (P + M) cross-sectional area (CSA). Plaque composition was classified as lipid pool, fibrosis, dense fibrosis, and calcification using IB-IVUS. The average length and diameter of DCB were 18.7 ± 5.0 and 2.6 ± 0.4 mm, respectively. Acute lumen gain correlated better with vessel dilatation than plaque reduction. Overall mean EEM, P + M, and lumen CSA did not change significantly during follow-up. The Δlumen CSA was negatively correlated with the ΔP + M CSA (r=-0.66, p < 0.001) and positively correlated with ΔEEM CSA (r = 0.52, p < 0.001). By IB-IVUS, ΔP + M CSA correlated positively with both Δfibrosis area and Δlipid pool area. Late lumen gain (Δ lumen CSA > 0) was documented in 30 lesions (65%). Lesions with late lumen gain showed a greater increase in EEM CSA (P = 0.006) and a greater decrease in P + M CSA (P = 0.007), respectively. In conclusion, de novo coronary lesions treated with DCB demonstrated lumen patency with preserved P + M and EEM CSA. A combination of arterial remodeling and plaque changes affected lumen changes during follow-up.

Graphical Abstract