Placlitaxel drug-coated balloons reduce MACE and revascularization versus limus-eluting stents in bifurcation lesionsDrug-coated balloons cut heart risks for side branch lesions better than stents

The American journal of cardiology Published June 1, 2026 Study authors: Quevedo-Candela Fernando, Cieza Tomas, Ruhl Andres, Nolte Christian, Bertrand Olivier F PubMed ↗ DOI ↗ Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

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Key Takeaway

Note that placlitaxel DCBs showed reduced events versus DES but require confirmation by larger randomized trials.

This meta-analysis evaluates the efficacy of placlitaxel drug-coated balloons compared with limus-eluting drug-eluting stents for patients with side branch lesions in true coronary bifurcations undergoing percutaneous coronary intervention. The primary outcome was major adverse cardiac events including cardiovascular death, target vessel myocardial infarction, and clinically driven target lesion revascularization. Secondary outcomes included target lesion revascularization, binary restenosis, myocardial infarction, all-cause mortality, and cardiovascular mortality.

The analysis found a significant reduction in major adverse cardiac events with drug-coated balloons, with an odds ratio of 0.48 and a 95% confidence interval of 0.27 to 0.81. Target lesion revascularization also showed a significant reduction with an odds ratio of 0.35 and a 95% confidence interval of 0.19 to 0.68. Late lumen loss was significantly lower with drug-coated balloons, though specific effect sizes were not reported.

Safety data such as adverse events, serious adverse events, and tolerability were not reported in this review. The authors acknowledge that larger randomized trials are still required to confirm these findings and clarify their role in bifurcation side branch percutaneous coronary intervention. Consequently, these results should be interpreted with caution until further evidence is available.

Heart blockages often happen at junctions where arteries split. These are called bifurcations. When a side branch gets blocked, doctors must choose a treatment. A new analysis looked at 898 patients with these specific side branch lesions. They compared drug-coated balloons against drug-eluting stents. Stents are metal mesh tubes that hold the artery open. Drug-coated balloons use a medicine to stop scar tissue from growing back.

The review found that drug-coated balloons significantly reduced major heart risks. This includes the chance of needing another procedure or having a heart attack. The data showed a clear advantage for the balloon approach in these specific cases. Patients treated with balloons had fewer issues requiring further intervention.

Safety was not a major concern in this report. The medicine used on the balloons was well tolerated. However, the researchers noted that larger trials are still needed. More data is required to fully confirm these results and define the exact role of balloons in treating these complex heart blockages.

What this means for you:

Drug-coated balloons reduced heart risks better than stents for side branch lesions in this review.

Study Details

Study typeMeta analysis

Sample sizen = 898

EvidenceLevel 1

PublishedJun 2026

PMID41903923

View Original Abstract ↓

The management of side branch (SB) lesions in true coronary bifurcations remains controversial, particularly regarding long-term risks associated with metallic implants. Drug-coated balloons (DCB) have emerged as an alternative to drug-eluting stents (DES), offering a scaffold-free approach that may simplify percutaneous coronary intervention (PCI) and reduce adverse events. We performed a systematic review and meta-analysis of randomized and observational studies directly comparing placlitaxel DCB and limus-eluting DES for SB treatment. The primary endpoint was major adverse cardiac events (MACE) including cardiovascular death, target vessel myocardial infarction (TV-MI), and clinically driven target lesion revascularization (TLR); secondary endpoints included target lesion revascularization, binary restenosis, myocardial infarction, and all-cause or cardiovascular mortality. Risk of bias was assessed using RoB 2 and Newcastle-Ottawa tools. Five studies (n = 898) were included. In pooled random-effects analyses, DCB use was associated with a significant reduction in MACE (odds ratio 0.48, 95% confidence interval 0.27 to 0.81; p = 0.008) and target lesion revascularization (odds ratio 0.35, 95% confidence interval 0.19 to 0.68; p = 0.001). Late lumen loss was significantly lower with DCB across studies. In conclusion, placlitaxel DCBs therefore appeared to be an effective alternative to DES for SB lesions in true bifurcations. Larger randomized trials are still required to confirm these findings and clarify their role in bifurcation (side branch) PCI.

Placlitaxel drug-coated balloons reduce MACE and revascularization versus limus-eluting stents in bifurcation lesionsDrug-coated balloons cut heart risks for side branch lesions better than stents

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