Conversation in Interventional Cardiology: Drug-Coated Balloons for De Novo Non–aorto-ostial and Coronary Bifurcation Lesions: A Systematic Review and Meta-analysis-Drug-Coated Balloons for De Novo Non–aorto-ostial and Coronary Bifurcation Lesions: A Systematic Review and Meta-analysis

Drug-Coated Balloons for De Novo Non–aorto-ostial and Coronary Bifurcation Lesions: A Systematic Review and Meta-analysis

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Video Summary

This J-Sky Conversations episode discusses a systematic review and meta-analysis of 11 studies (2,443 patients) comparing drug-coated balloons (DCBs) with drug-eluting stents or balloon angioplasty for de novo coronary bifurcation and non-ostial lesions. The pooled analysis found DCBs were associated with significantly lower target lesion failure overall (risk ratio 0.52), with consistent benefit across subgroups including randomized trials, bifurcation lesions, non-ostial lesions, DES comparators, and balloon angioplasty comparators.  <br /><br />The panel emphasized that DCBs may be especially useful in complex disease, such as small vessels, diffuse lesions, and bifurcations, because they offer a “leave nothing behind” strategy and may reduce long-term stent-related issues and prolonged dual antiplatelet therapy. Speakers also discussed ongoing trials, including the Solution studies, and noted that more robust randomized data are needed before DCBs can become first-line therapy in guidelines.

Asset Caption

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Keywords

drug-coated balloons

coronary bifurcation lesions

target lesion failure

drug-eluting stents

systematic review meta-analysis

leave nothing behind strategy