Vasomotor Activity and outcomes in percutaneous coronary intervention

Gunawardena, Tharusha (2023) Vasomotor Activity and outcomes in percutaneous coronary intervention. Doctoral thesis, University of East Anglia.

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Abstract

In 2017/2018 there were over 102,000 percutaneous coronary interventions performed in the UK according to the British Cardiovascular Interventional Society data, representing an 1.5% annual increase and its use continues to increase with the greater heart disease awareness amongst the public. I firstly assessed the effects of percutaneous coronary intervention using either drug eluting stents or drug coated balloons on coronary vasomotion which is a technique utilised to identify endothelial dysfunction. There was no difference in endothelial dysfunction between drug eluting stents and drug coated balloons.

I performed a meta analysis to look at acute complications following drug eluting stents or drug coated balloons across multiple treatment centres and this showed no significant difference in acute vessel closure, target lesion revascularisation and major adverse cardiac outcomes between the two groups.

I then examined data regarding patients who had received either drug eluting stents or drug coated balloons for the treatment of left main stem coronary artery disease and analysed their outcomes. I showed for the first time that drug coated balloon treatment whilst also removing some of the strategic complexity of treating this high risk population, was safe, and could thus be considered as a practical alternative to drug eluting stents in appropriate settings.

Finally, for patients who were being treated for acute coronary syndromes I compared individuals that received drug coated balloons or drug eluding stents, again showing no difference in outcomes.

In conclusion, this thesis investigated the alternative use of drug coated balloon angioplasty in patients with coronary artery disease and showed no difference in outcomes in all the settings studies.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Chris White
Date Deposited:	03 Feb 2026 08:54
Last Modified:	03 Feb 2026 08:54
URI:	https://ueaeprints.uea.ac.uk/id/eprint/101818
DOI:

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