Necessity of Percutaneous Coronary Intervention Evaluated by Low-Pressure Balloon Occlusion and Improvement of Postoperative Clinical Symptoms in Patients with Intermediate Lesions.

Objective: The value of low-pressure balloon occlusion (LPBO) technology was investigated to evaluate the necessity of percutaneous coronary intervention (PCI) and the improvement of postoperative clinical symptoms in patients with intermediate lesions. Furthermore, the feasibility and safety of this technique were validated. Methods: Forty-eight patients with intermediate lesions identified during angiography at the Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, were enrolled and randomly assigned to the treatment group and the control group. In the treatment group, PCI was guided by LPBO. In the control group, PCI was guided by intravascular ultrasound (IVUS) or optical coherence tomography (OCT). Symptom intensity, symptom similarity scores, and PCI implantation rates were collected during the procedure. The clinical symptom improvement rate and the incidence of major adverse cardiovascular events (MACE) were observed during hospitalization and follow-up. Results: In the treatment group (n=24), 10 patients experienced symptoms similar to their pre-hospitalization condition during LPBO and subsequently underwent PCI, resulting in symptom resolution. The remaining 14 patients with low symptom similarity scores showed good prognosis after intensive medical therapy. In the control group (n=24), 18 patients met the minimum lumen area (MLA) criteria via IVUS/OCT and received PCI. The PCI implantation rate in the treatment group was significantly lower than that in the control group (P < 0.05). Significant improvement in Seattle Angina Questionnaire (SAQ) scores was observed in 18 patients (75%) in the treatment group compared to 8 patients (33.3%) in the control group (P < 0.05). At the 6-month follow-up, no MACE occurred in the treatment group (n=24, 0.0%). In the control group, 2 cases of target vessel revascularization (TVR) occurred (2/24, 8.3\%), with no cardiac deaths or non-fatal myocardial infarctions. No significant difference in MACE incidence was found between the two groups. No complications related to LPBO, such as dissection or plaque rupture, were observed. Conclusion: LPBO technology effectively correlates coronary stenosis with clinical symptoms. It provides a reliable basis for PCI decision-making in patients with intermediate lesions. This technique is safe and feasible. It has the potential to reduce unnecessary stent implantation and improve patient prognosis.