At EuroPCR 2026, Dr. Rui Zhang (Fuwai Hospital, China) presented a retrospective study of 423 patients with de novo large coronary vessels (RVD ≥3.0mm) treated with DCB only.

🔍 Key finding
Preprocedural RWSmax ≥13% identified lesions with a nearly 7fold higher adjusted risk of 3year target vessel failure (aHR 6.90, logrank P<0.001).
TVF rate: 15.8% in highrisk vs. 1.9% in lowrisk group.

📊 Performance
RWSmax alone predicted TVF with AUC 0.84, significantly improving the base clinical model (AUC 0.65 → 0.85).

💡 Clinical implication
RWS offers a practical angiographyderived tool to decide between DCBonly (low RWS) or more aggressive PCI (high RWS) – potentially guiding lesionspecific treatment.

✅ Takeaway
Elevated RWS identifies highrisk largevessel lesions after DCB, supporting tailored procedural strategy.

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