Objective: The aim of this study was to evaluate the efficacy of scoring balloon angioplasty for drug-coated balloon (DCB) treatment in percutaneous coronary intervention. Background: The scoring balloon angioplasty may play a pivotal role in enhancing the outcomes of DCB treatment. Methods: A total of 259 patients (278 lesions) with coronary artery disease successfully treated with DCB were retrospectively enrolled. The mean age of the patients was 62.2 ± 11.1 years, and the majority of patients were men (68.7%). The study’s endpoint was defined as achieving an optimal angiographic result, which consisted of Thrombolysis in Myocardial Infarction (TIMI) flow grade 3, residual diameter stenosis ≤ 30%, and dissection less than type C after the procedure. Results: Angioplasty was performed for 61 lesions with a scoring balloon and 217 lesions with a non-scoring balloon. All lesions were TIMI flow grade 3 except two lesions in the non-scoring balloon group. The scoring balloon group had a higher prevalence of residual diameter stenosis ≤ 30% (68.9% vs. 39.6%, p < 0.001), while severe dissection, defined as type C or greater, was observed less frequently (9.8% vs. 31.8%, p = 0.001). Moreover, the scoring balloon group achieved a superior rate of optimal angiographic results (60.7% vs. 28.6%, p < 0.001). In multivariable analysis, scoring balloon (OR: 3.08 [95% confidence interval, 1.47–6.58], p = 0.003) and DCB balloon-to-artery ratios (OR: 5.46 [95% confidence interval, 1.43–21.93], p = 0.014) were independent factors in the increasing rate of optimal angiographic result. Conclusions: The application of a scoring balloon catheter for lesion preparation, aiming to make them suitable for DCB treatment, was associated with a decreased risk of severe dissection and a greater occurrence of optimal angiographic outcomes compared with non-scoring balloon angioplasty.

Hui L, et al. Yonsei Med J. 2020 Dec;61(12):1004-1012. https://doi.org/10.3349/ymj.2020.61.12.1004

Kun L, et al. Yonsei Med J. 2021 Nov;62(11):981-989. https://doi.org/10.3349/ymj.2021.62.11.981

Aims: Acute coronary syndrome (ACS) exhibits marked sex-related differences in clinical presentation and underlying pathophysiology. However, whether these differences translate into variations in culprit lesion prediction remains unclear. We investigated the sex-specific performance of conventional coronary computed tomography angiography (CCTA) and artificial intelligence-enabled quantitative coronary plaque and haemodynamic assessment (AI-QCPHA) for ACS culprit detection. Methods and results: In this sub-study of the EMERALD II trial (NCT03591328), patients with ACS who underwent CCTA 1 month to 3 years prior to the event were analysed. Culprit and non-culprit lesions were defined by invasive coronary angiography at the time of ACS. Diagnostic performance of obstructive stenosis (Coronary Artery Disease-Reporting and Data System ≥ 3) and high-risk plaque (HRP) criteria was compared between women and men. Information gain-based feature selection identified sex-specific AI-QCPHA best predictors across five feature clusters, and their incremental predictive value was evaluated using receiver operating characteristics reported as area under the curve (AUC). A total of 351 patients (90 women, 261 men) with 2451 lesions were included. Conventional CCTA performed similarly across sexes for obstructive stenosis, whereas HRP differed by sex. AI-QCPHA identified the same best features for ACS culprit prediction in both sexes, and integration of these features improved discriminatory performance beyond conventional CCTA (women AUC 0.84 vs. 0.78, P = 0.002; men 0.82 vs. 0.75, P < 0.001). Among individual predictors, delta fractional flow reserve from coronary computed tomography angiography yielded the highest discriminatory performance in both women and men. Conclusion: AI-QCPHA enhances culprit lesion prediction in obstructive ACS beyond conventional CCTA in both sexes, supporting its potential role for improved culprit lesion discrimination.

Shin ES, et al. Yonsei Med J. 2026 Sep;67(9):663-670. https://doi.org/10.3349/ymj.2025.0512