Abstract Background Drug-eluting stents (DES) are a normative care of coronary stenosis. However, despite improving clinical outcomes with the latest generation DES, their efficacy was limited by stent thrombosis and in-stent restenosis especially in small vessel coronary artery disease (SvCAD). The aim of this study was to assess the angiographic efficacy and long term clinical outcomes of drug coated balloons (DCB) as compared with DES in patients with SvCAD. Methods A total of 100 SvCAD patients who underwent percutaeous coronary intervention (PCI) of culprit coronary arteries 3 mm diameter and 70% stenosis were enrolled in this study. The patients were categorized into DES arm and DCB arm. One year clinical outcomes were assessed. The primary endpoint was in-lesion late lumen loss (LLL). The secondary endpoints were vessel thrombosis, major bleeding, all-cause death and major adverse cardiac events (MACEs) including cardiac death, non-fatal myocardial infarction (MI), target lesion revascularization (TLR) and target vessel revascularization (TVR). Results One year clinical follow-up revealed that in-lesion LLL was significantly lower in DCB arm as compared with DES arm (0.06 ± 0.12 vs. 0.14 ± 0.17 mm, P = 0.004). Composite MACE was significantly higher in DES group compared to DCB group (50% vs. 12%, P 0.001). Non-fatal MI, TLR, and major bleeding in DES group were significantly higher than DCB group (16% vs. 4%, P = 0.04 0.001 but not significantly, higher incidence of cardiac death (6% vs. 4%, P = 0.65), and vessel thrombosis (14% vs. 6%, P = 0.18) in DES arm compared to DES arm. Conclusions In SvCAD setting, DCB has a favourable angiographic outcome; as evidenced by lower in lesion LLL, and significantly reduced rates of composite MACE, non-fatal MI, TLR, and major bleeding at one year follow up in comparison to DES.
Refaat et al. (Sat,) studied this question.