Abstract：ObjectiveTo compare the efficacy of drugcoated balloon (DCB) and drugeluting stents (DES) for de novo diffuselong lesion in macrovascular coronary artery, so as to explore the chances of DCB as a routine therapy. MethodsWe enrolled 102 patients with uncomplex de novo diffuselong lesions in macrovascular coronary artery who had undergone coronary intervention therapy. They were divided into DCB group and DES group according to intervention strategies. Quantitative flow ratio (QFR) technology was used to analyze the characteristics of lesions before intervention, immediately after intervention and during oneyear followup after intervention. The curative effect was compared between DCB and DES. Results(ⅰ) There were no statistically significant differences in clinical data. (ⅱ) There were no statistically significant differences between the two groups in the site of intervention vessels, the proportion of singlevessel and bifurcated lesions, and the use of antiplatelet drugs. In terms of pretreatment, the proportion of nonslip element balloon used in the DCB group was significantly higher than that in the DES group (P<0.05). (ⅲ) The results of QFR analysis showed that there were no statistically significant differences in the reference vessel diameter, lesion length, and stenosis rate of lesion area before intervention between the two groups (P>0.05). Immediately after intervention, the minimum lumen diameter ［(2.57±0.27)mmvs. (2.95±0.46)mm, P<0.01］, and QFR gain ［0.22(0.17,0.53) vs. 0.27(0.20,0.63), P=0.001］ in the DCB group were both lower than those in the DES group, while the stenosis rate of residual area was significantly higher than that in the DES group ［(27.80±7.29)%vs. (13.08±6.93)%, P<0.01］. During followup, Although the stenosis rate of lesion area in the DCB group was higher than that in the DES group ［3876(3056,4816)%vs. 2714(2022,3475)%, P＜001］, the late lumen loss was smaller than that in the DES group ［0.19(0.05,0.30)mmvs. 0.25(0.15,0.39)mm, P=0.030］. The minimum lumen diameter did not vary significantly between groups (P>0.05). (ⅳ) There was no statistically significant difference in the incidence of major adverse cardiovascular events (MACE) between the two groups during followup (all P>0.05). ConclusionThe efficacy and the incidence of MACE of DCB guided by QFR are similar to that of DES for uncomplex de novo diffuselong lesion in macrovascular coronary artery. However, in consideration of the small sample size of this study, more evidences are needed to support the clinical application of DCB for de novo diffuselong lesion in macrovascular coronary artery.
