Drug-coated versus conventional balloons for side branch treatment in coronary bifurcation lesions: an optical coherence tomography substudy of the OCVC-BIF randomised trial

作者：Daisuke Nakamura, Takayuki Ishihara, Tomoharu Dohi, Daisuke Sakamoto, Shumpei Kosugi, Naotaka Okamoto, Atsushi Kikuchi, Tsutomu Kawai, N Mori, Ryu Shutta, Minoru Ichikawa, Yasunori Ueda, Toshiaki Mano, M Nishino, Tetsuya Watanabe, Yoshiharu Higuchi, Eisuke Hida, Tomoharu Sato, Shungo Hikoso, Daisaku Nakatani, Yohei Sotomi, Yasushi Sakata, on behalf of the OCVC-BIF investigators · 发表于：EuroIntervention · 年份：2026 · DOI：10.4244/eij-d-26-00428 · 被引用次数：1 · 研究领域：Coronary Interventions and Diagnostics、Peripheral Artery Disease Management、Retinal Diseases and Treatments

BACKGROUND: Coronary bifurcation lesions remain prone to side branch (SB) ostial restenosis. Kissing balloon inflation (KBI) is the standard of care for provisional stenting, but it induces mechanical injury. Drug-coated balloons (DCBs) may pharmacologically inhibit neointimal hyperplasia to improve long-term patency. AIMS: We sought to evaluate mechanistic vascular healing and luminal changes of the SB after adjunctive SB-DCB versus SB-conventional balloon treatment using high-resolution serial optical coherence tomography (OCT). METHODS: The randomised OCVC-BIF trial compared adjunctive SB-DCB (n=149) with non-DCB treatment (n=150) following main vessel stenting and protocolled KBI. The present prespecified study was restricted to those patients who completed analysable follow-up OCT pullbacks (n=221). Endpoints included the SB volume change and the main vessel stent healing parameters. RESULTS: There was no significant difference in the ostium, minimum SB area, or SB volume between the DCB and non-DCB groups following percutaneous coronary intervention (PCI). Serial OCT analysis showed that the DCB group exhibited a lumen volume gain at the SB of 0.14±5.64 mm3 from post-PCI to 9-month follow-up, whereas the non-DCB group showed a mean loss of 2.15±9.51 mm3. Although this difference reached statistical significance in the prespecified parametric analysis (p=0.042), in the sensitivity analysis using the Wilcoxon rank-sum test, the difference was attenuated (0.45 [interquarti...