Drug eluting balloon versus drug eluting stent in percutaneous coronary interventions: insights from a meta-analysis of 1462 patients.
BACKGROUND
Drug eluting balloons (DEB) have been developed to overcome the limitations of drug eluting stents (DES), but clinic results of various DEB studies are still not consistent. Thus, we performed a meta-analysis to compare outcomes of DEB and DES for the treatment of coronary artery disease (CAD).


METHODS
Medline/Web databases were searched for studies comparing DEB and DES for obstructive CAD, reporting late lumen loss (LLL) and rates for overall mortality, myocardial infarction (MI), stent thrombosis (ST) and target lesion revascularization (TLR).


RESULTS
8 studies (1462 patients) were included in the meta-analysis. Compared with DES, DEB treated patients showed non-significantly higher LLL (weighted mean difference [WMD] 0.32, 95% confidence interval [CI] -0.15 to 0.78, P=0.18) and non-significantly higher rate of binary restenosis (odds ratio [OR] 1.40 [0.68-2.48], P=0.36). Mortality (OR 1.13[0.54-2.37], P=0.74), MI (OR 0.95, [0.50-1.80], P=0.87), ST (OR 1.12, [0.34-4.19], P=0.77) and TLR rates (OR 1.19[0.60-2.38], P=0.61) were similar between the 2 treatments. A pre-specified meta-regression analysis showed that LLL WMD and TLR OR were inversely correlated to the prevalence of diabetes (P<0.0001) and directly correlated to reference coronary diameters (P<0.001).


CONCLUSIONS
The present meta-analysis showed that compared to DES, DEB use resulted in similar clinical efficacy and safety. Thus DEB could be considered a reasonable alternative to DES for the treatment of CAD in selected clinical settings (Clinicaltrials.gov identifier: NCT01760200).
Hospital Cardiology, "Maggiore della Carità" Hospital, Novara, Italy. Electronic address: lupialessandro1@tin.it.
Alessandro
A
Lupi
Andrea
A
Rognoni
Gioel Gabrio
GG
Secco
Italo
I
Porto
Federico
F
Nardi
Maurizio
M
Lazzero
Lidia
L
Rossi
Rosario
R
Parisi
Rossella
R
Fattori
Giulia
G
Genoni
Roberta
R
Rosso
Pieter R
PR
Stella
Imad
I
Sheiban
Leonardo
L
Bolognese
Francesco
F
Liistro
Angelo Sante
AS
Bongo
Pierfrancesco
P
Agostoni
D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D003324:Coronary Artery Disease / Q000601:surgery*; D054855:Drug-Eluting Stents; D004867:Equipment Design; D006801:Humans; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D016896:Treatment Outcome
Angioplasty; Drug-eluting balloons; Drug-eluting stents; Meta-analysis; Paclitaxel; Stents