A meta-analysis of the efficacy of limus-coated balloons vs. paclitaxel-coated balloons for coronary artery disease

Objective To evaluate the efficacy of limus-coated balloons (Limus-DCB) compared with paclitaxel-coated balloons (PCB) in the treatment of coronary artery disease. Methods We searched PubMed, Embase, Cochrane Library, and Web of Science for randomized controlled trials (RCTs) comparing Limus-DCB with PCB for coronary artery disease from inception to June 2026. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was performed using RevMan 5.4.1 software. Results A total of 10 studies involving 11 RCTs with 1,707 patients and 1,804 treated vessels were included. The meta-analysis showed that the Limus-DCB group was associated with marginally greater in-segment late lumen loss (LLL) (MD = 0.10, 95% CI 0.00–0.19, P = 0.04) and marginally smaller in-lesion minimal lumen diameter (MLD) (MD = −0.10, 95% CI −0.19 to 0.00, P = 0.04). There were no significant differences between the two groups in in-lesion LLL, late lumen enlargement (LLE), binary restenosis rate, target lesion failure (TLF), or major adverse cardiovascular events (MACE). Conclusions Based on current evidence, compared with PCB, Limus-DCB are associated with less favorable angiographic outcomes in the treatment of coronary artery disease. However, no statistically significant short-term clinical differences were detected between the two groups. Due to the limitations in the quantity and quality of the included studies, these findings need to be verified by more high-quality research. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/recorddashboard , identifier CRD420251153751.