Hybrid (DES + DCB) strategy for chronic total occlusions: Development of the GLOW risk stratification score
Abstract
Background
Hybrid drug-eluting stent/drug-coated balloon percutaneous coronary intervention (DES-DCB PCI) aims to minimize stent burden while maintaining patency in chronic total occlusion lesions.
Methods
We prospectively studied 19 consecutive CTO patients treated with a hybrid DES–DCB strategy; primary endpoint was late lumen loss (LLL) at 3–4 months, with secondary clinical outcomes at six months.
Results
Technical success was 89.5 %; mean LLL was 0.10 ± 0.83 mm; late lumen gain occurred in ~53 % of patients completing angiographic follow-up; binary restenosis was 10.5 %. Residual stenosis strongly predicted LLL, while optimal DCB sizing and inflation ≥180 s were protective; residual stenosis remained the independent predictor in multivariable regression. IVUS guidance was associated with 0 % restenosis.