August 15, 2025Open Access

2-049 Evaluating the practice and clinical outcomes of the use of drug coated balloons in a district general hospital

Key Points

Overall complications were less for drug-coated balloons at 11.4% compared to 34.5% for standard PCI, revealing a significant difference in patient outcomes.
In a cohort of 172 patients, 68% had acute coronary syndrome, indicating a high-risk population utilized in the study.
This retrospective analysis compared drug-coated balloons to other PCI methods, highlighting potential advantages in outcomes for small vessel lesions.
Further research is encouraged to validate findings and explore broader uses of drug-coated balloons beyond small vessel interventions.

Abstract

Introduction Drug-coated balloons (DCB) are an established treatment strategy for coronary artery disease. This delivery of antiproliferative agents to the vessel wall is a reasonable alternative, particularly when stent insertion is undesirable. Presently, DCB is indicated for in-stent restenosis, small vessel disease, de novo coronary lesions, high bleeding risk patients and bifurcation disease. The aim of this retrospective review was to assess the use of DCB in everyday practice in a district general hospital and assess the clinical outcomes compared to standard percutaneous coronary intervention (PCI). Methods This was a retrospective study design. Inclusion criteria consisted of patients undergoing primary coronary intervention utilising DCB, plain balloon angioplasty (POBA) or an alternative PCI strategy from February 2018 to February 2022. Data was collected for patient demographics and complications including dissection, reintervention and/or death. Outcomes were compared with Chi-squared. Results A total of 172 patients were included, of which 79% were male and 21% female. In 68% of cases, the indication for PCI was acute coronary syndrome, 31% stable angina and 1% atypical angina. DCB was used for 98 cases, POBA in 12 cases, both DCB and POBA for 13 cases, and an alternative PCI strategy in 62 cases. Overall, complications including dissection, perforation and re-do of the procedure for those undergoing DCB compared to standard PCI was less (11.4% vs 34.5%, pConclusion The use of DCB for treatment coronary artery disease did not worsen outcomes compared to standard PCI (POBA, drug eluting stents) for small vessel de-novo lesions. However, the magnitude of this assertion has to be balanced with our patient population size and potential selection bias given the retrospective nature of the study design. We therefore encourage greater research into the use of DCB to evaluate their wider implications in PCI, including in large vessel intervention as there remains a paucity in the data as well as prospective studies to strengthen the conclusions we can draw.

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