Related Experiment Video
Updated: Sep 14, 2025
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Drug-coated balloon-based versus drug-eluting stent-only treatment for single de novo diffuse coronary lesions
Eun-Seok Shin1, Sunwon Kim2, Dong Oh Kang3
1Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.
Insights
Drug-coated balloon (DCB) angioplasty significantly reduced major adverse cardiovascular events (MACE) in patients with de novo diffuse coronary artery disease (CAD). This DCB-based percutaneous coronary intervention (PCI) proved safer and more effective than drug-eluting stent (DES)-only PCI over two years.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Medicine
Background:
- Limited data exist on drug-coated balloon (DCB) treatment for de novo diffuse coronary artery disease (CAD).
- Percutaneous coronary intervention (PCI) is a common treatment for CAD, but diffuse disease presents challenges.
Purpose of the Study:
- To evaluate the clinical impact of DCB-based PCI in patients with de novo diffuse long CAD.
- To compare the efficacy and safety of DCB-based PCI versus conventional PCI with drug-eluting stents (DES) in this patient population.
Main Methods:
- Retrospective study including 623 patients with de novo diffuse CAD (≥ 30mm) treated with DCB-based PCI.
- Propensity-matched comparison with 623 patients treated with DES-only PCI.
- Primary endpoint: major adverse cardiovascular events (MACE) at 2 years, including cardiac death, myocardial infarction, thrombosis, target vessel revascularization, and major bleeding.
Main Results:
- The 2-year MACE rate was significantly lower in the DCB-based group (4.6%) compared to the DES-only group (14.6%).
- DCB-based PCI showed lower rates of target vessel revascularization (3.1% vs 9.7%) and major bleeding events (0.8% vs 2.7%).
- Multivariable analysis confirmed DCB-based PCI was independently associated with reduced risk of MACE, TVR, and major bleeding.
Conclusions:
- DCB-based PCI significantly reduced MACE in patients with de novo diffuse CAD compared to DES-only PCI.
- DCB-based PCI offers a promising alternative treatment strategy for diffuse coronary artery disease.
Introduction And Objectives:
There are limited data on drug-coated balloon (DCB) treatment for de novo diffuse coronary artery disease (CAD). This study aimed to evaluate the clinical impact of DCB-based percutaneous coronary intervention (PCI) in patients with de novo diffuse long CAD.
Methods:
We retrospectively included 623 patients with single de novo diffuse CAD (≥ 30mm). These patients underwent PCI exclusively for the target lesion and were successfully treated with DCB-based PCI. They were compared with 623 propensity-matched patients who underwent conventional PCI with second-generation drug-eluting stents (DES) for diffuse CAD (DES-only group). The primary endpoint was major adverse cardiovascular events (MACE), defined as a composite of cardiac death, myocardial infarction, stent or target lesion thrombosis, target vessel revascularization, and major bleeding at 2 years.
Results:
In the DCB-based group, 73.7% of patients were treated with DCB alone. The MACE rate was significantly lower in the DCB-based group than in the DES-only group (4.6% vs 14.6%; HR, 0.29; 95%CI, 0.18-0.47; P<.001). Rates of target vessel revascularization (3.1% vs 9.7%; P<.001) and major bleeding events (0.8% vs 2.7%; P=.008) were also lower with DCB-based PCI than with DES-only PCI. In a multivariable model, DCB-based PCI was independently associated with a lower risk of 2-year MACE, target vessel revascularization, and major bleeding.
Conclusions:
In patients with de novo diffuse CAD, DCB-based PCI was associated with a significant reduction in MACE compared with DES-only PCI.
Related Concept Videos
01:27Coronary Artery Disease V: Interprofessional Care
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:18Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...