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Physiology-guided percutaneous coronary intervention using drug-coated balloon versus drug-eluting stent: a

Domenico Galante1, Ciro Pollio Benvenuto2,3, Simona Todisco2

  • 1Center of Excellence of Cardiovascular Sciences, Ospedale Isola Tiberina - Gemelli Isola.

Journal of Cardiovascular Medicine (Hagerstown, Md.)
|May 26, 2026
PubMed

Insights

Physiology-guided drug-coated balloon percutaneous coronary intervention (ph DCB-PCI) shows similar outcomes to drug-eluting stent PCI. This suggests a potential role for physiological assessment in stentless revascularization.

Area of Science:

  • Cardiovascular Interventions
  • Medical Device Technology

Background:

  • Physiology-guided drug-eluting stent PCI improves outcomes.
  • Clinical benefit of physiology-guided drug-coated balloon PCI is not well-established.

Purpose of the Study:

  • To compare the clinical outcomes of physiology-guided drug-coated balloon PCI versus physiology-guided drug-eluting stent PCI.
  • To evaluate the feasibility and safety of physiology-guided drug-coated balloon PCI.

Main Methods:

  • Propensity-matched analysis of 39 patient pairs from the PROPHET-FFR registry.
  • Comparison of major adverse cardiovascular events (MACE) and target-vessel revascularization rates.

Main Results:

  • Similar MACE rates at 13 months between ph DCB-PCI and ph DES-PCI groups (5.1% vs 7.6%, P=0.644).
  • Target-vessel revascularization rates were comparable (2.6% vs 7.6%, P=0.305).
  • One periprocedural myocardial infarction occurred in the ph DCB-PCI group.

Conclusions:

  • Physiology-guided DCB-PCI is feasible in selected patients.
  • No worse outcomes observed with ph DCB-PCI compared to ph DES-PCI.
  • Physiological assessment may support stentless revascularization strategies.
Abstract

Keywords:
#FullPhysiologydrug-coated balloondrug-eluting stentfractional flow reservephysiology-guided percutaneous coronary intervention

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