What does this research mean for the field?

DCB-only angioplasty is as safe and effective as DES for multivessel angioplasty, with no significant difference in major adverse cardiovascular events after 4 years of follow-up. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The central aim is to evaluate the safety and effectiveness of drug-coated balloon-only angioplasty for patients with multivessel coronary artery disease.

January 10, 2026Journal of Clinical Medicine0 citationsOpen Access

Assessment of Paclitaxel Drug-Coated Balloon-Only Angioplasty for Multivessel Coronary Artery Disease

IMIoannis MerinopoulosInterventional Cardiology NCNatasha CorballisUniversity of East Anglia UBU BhalraamUniversity of East Anglia

Key Result

DCB-only angioplasty and DES showed no significant difference in major adverse cardiovascular events (33% in both groups) after 4 years of follow-up.

Key Points

The central aim is to evaluate the safety and effectiveness of drug-coated balloon-only angioplasty for patients with multivessel coronary artery disease.
Comparison of major adverse cardiovascular events between DCB-only and DES-only strategies.
Data collected from January 2015 to November 2019.
Analysis included Cox regression models and Kaplan–Meier plots.
Propensity score matching was used for data comparison.
A total of 159 patients received DCB angioplasty; 222 received DES angioplasty.
After a median follow-up of 4 years, 33% experienced MACEs in both groups (p = 0.97).
Atrial fibrillation and diabetes were identified as independent predictors of MACEs.

Structured PICO

Does paclitaxel drug-coated balloon-only angioplasty improve or maintain safety and efficacy compared to second-generation drug-eluting stents in patients undergoing multivessel angioplasty?

Population

381 consecutive patients undergoing multivessel angioplasty (majority of treated vessels >3 mm)

Intervention

Paclitaxel drug-coated balloon (DCB)-only angioplasty

Comparator

Second-generation drug-eluting stents (DES)-only angioplasty

Outcome

Major adverse cardiovascular events (MACE), defined as a composite of cardiovascular mortality, acute coronary syndrome, target lesion revascularisation, stroke, or major bleedingcomposite

A paclitaxel drug-coated balloon-only strategy demonstrated comparable long-term clinical outcomes to second-generation drug-eluting stents in patients undergoing multivessel coronary angioplasty.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Background: There are limited data about the use of drug-coated balloon (DCB)-only angioplasty for multivessel coronary disease. Objectives: The aim of this study was to assess the safety and efficacy of DCB-only angioplasty as compared with second-generation drug-eluting stents (DESs) in patients undergoing multivessel angioplasty. Methods: We compared major adverse cardiovascular events (MACEs) in all patients undergoing multivessel angioplasty in our institution from 1 January 2015 until 15 November 2019, with either the DCB-only or DES-only strategy. The primary endpoint of our study was a MACE, including cardiovascular mortality, acute coronary syndrome, target lesion revascularisation, stroke, or major bleeding. Data were analysed using Cox regression models, Kaplan–Meier estimator plots, and propensity score matching. Results: A total of 159 consecutive patients treated with DCB-only angioplasty and 222 consecutive patients treated with DES-only angioplasty were identified. The majority of the vessels treated were large vessels (>3 mm). After a median follow-up of 4 years, a total of 52 (33%) patients in the DCB and 73 (33%) patients in the DES group encountered a MACE (p = 0.97). The results did not change following propensity score matching. On multivariate Cox regression analysis in the propensity score-matched cohort, atrial fibrillation HR = 2.37, CI: (1.22–4.61), p = 0.011 and diabetes HR = 1.71, CI: (1.13–2.60), p = 0.011 were the only independent adverse predictors of MACE. Conclusions: DCB-only angioplasty appears to be safe and efficient when compared to DES for multivessel angioplasty in terms of MACEs after a follow-up of 4 years.

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