Drug coated balloons for coronary artery bifurcation lesions: a systematic review and focused meta-analysis

Natasha H. Corballis, Sophie Paddock, Tharusha Gunawardena, Ioannis Merinopoulos, Vassilios Vassiliou, Simon C. Eccleshall

Research output: Contribution to journalReview article

15 Downloads (Pure)

Abstract

Objectives

We sought to systematically review the evidence supporting the role of drug coated balloons (DCBs) in the treatment of coronary bifurcation lesions.

Background

DCBs are emerging as an attractive alternative treatment strategy for treating coronary bifurcations due to simplifying the approach and reducing rates of stent related complications. We systematically reviewed the evidence for DCB use in coronary bifurcations and conducted a focused meta-analysis on late lumen loss in the side branch comparing DCB and plain old balloon angioplasty (POBA).

Methods

This study was conducted in line with the PRISMA statement. All studies (including both RCTs and observational studies, excluding case reports) using DCB as part of a bifurcation strategy were included in this review. A literature search identified a total of ten studies for inclusion. A focused meta-analysis was undertaken for the use of DCB in side-branch compared with POBA. Mean late lumen loss was used with a random effects model due to heterogeneity.

Results

DCB was found to be superior to POBA for side branch treatment in bifurcations (p = 0.01). There are four studies that investigated the use of DCB for main branch treatment in a bifurcation, with evidence supporting its safety in main branches of bifurcation lesions, while prospective observational studies have demonstrated favourable target lesion revascularisation rates.

Conclusion

Although there is a lack of robust RCTs comparing DCBs with current generation DES, DCBs appear safe in main branch bifurcation lesions with improved side branch late lumen loss when compared with DES or POBA.
Original languageEnglish
Article numbere0251986
JournalPLoS One
Volume16
Issue number7
DOIs
Publication statusPublished - 9 Jul 2021

Cite this