Laser vaporization of atherothrombotic burden before drug‐coated balloon application in ST‐segment elevation myocardial infarction: Two‐year outcomes of the laser‐DCB trial

Abstract Objectives This study aimed to examine whether the combination of excimer laser coronary atherectomy (ELCA) and drug‐coated balloon (DCB) angioplasty can provide feasible clinical outcome in patients with ST‐segment elevation myocardial infarction (STEMI) with 8‐month and 2‐year scheduled follow‐up angiography. Background Intracoronary thrombus elevates the risk of interventional treatment in patients with STEMI and hampers drug absorption into the vasculature released from DCB. Methods Sixty‐two patients with STEMI within 24 h after the onset of symptoms were enrolled in this prospective, single‐center, single‐arm study. Results The laser catheter was successfully crossed distal to the culprit lesion in all cases. No ELCA‐related adverse events occurred. Bail‐out stenting was required in two patients (3.2%) after adjunctive ballooning; thus, the remaining 60 patients were completed with DCB angioplasty without stenting. Scheduled angiography at 8 months and 2 years was completed in 100% and 85.2%, respectively, and minimal lumen diameters were 3.4 ± 0.5, 3.4 ± 0.6, and 3.4 ± 0.5 mm after the procedure, at 8 months and at 2 years, respectively. Binary restenosis was observed in five patients (8.1%) in whom target lesion revascularization was performed. The duration of dual antiplatelet therapy was 2.3 ± 2.2 months, and neither abrupt vessel closure, reinfarction, cardiac death nor major bleeding was observed. Conclusion A combination of DCB angioplasty with ELCA is a feasible therapeutic option for STEMI.