Second‐Generation Drug‐Eluting Balloon for Ostial Side Branch Lesions (001‐Bifurcations): Mid‐Term Clinical and Angiographic Results

Background In the drug‐eluting stent era, the best strategy to treat Medina 001 lesion remains unestablished. This is the first prospective registry assessing the efficacy and safety of the second‐generation drug‐coated balloon in patients with side‐branch ostial lesion. Methods Forty‐nine patients with de novo Medina 001 lesion and associated myocardial ischemia were treated with second‐generation drug‐coated balloon—Dior balloon catheter (Eurocor GmbH, Bonn Germany), and prospectively included in this study. After mandatory pre‐dilatation, a paclitaxel‐eluting balloon was inflated for a minimum of 45 seconds. Left main bifurcation, severely calcified lesions and cardiogenic shock, were the only exclusion criteria. Results The inclusion period was 2.7 years. Mean age was 62 ± 12 years old, 41% diabetic, 65% presented with acute coronary syndrome. The most common vessel treated was the first diagonal (50%). Pre‐dilatation with a cutting balloon was used in 59%. Angiographic success was 86% (in 14% a bare metal stent was implanted because of acute recoil [n = 5] or coronary dissection more than type B [n = 2]). At a mean of 12.2 ± 2.2 months, major cardiac adverse events rate was 14.3% (1 myocardial infarction, 0 cardiac deaths, 7 target lesion revascularization). There was no thrombosis or occlusion. At a mean of 7.2 ± 1.1 months, binary restenosis was 22.5% (n = 7) with a late loss of 0.32 ± 0.73 mm. Conclusion Medina 001 lesion is an infrequent type of coronary lesion. Drug‐coated balloon—Dior is a safe and technically easy therapeutic option, associated with acceptable mid‐term clinical outcomes. (J Interven Cardiol 2016;29:285–292)