Abstract
BackgroundDrug-eluting balloons (DEB) have significant value for treating coronary artery disease (CAD). However, the merits of using DEB versus drug-eluting stents (DES) to treat CAD remain controversial. Herein, we conducted a meta-analysis to compare the safety and efficacy of DEB and DES for treatment of CAD.MethodsWe searched MEDLINE, EMBASE, and CENTRAL databases for eligible trials comparing DEB with DES for treatment of CAD. The primary endpoint was major adverse cardiac events (MACE); the secondary endpoints included in-lesion late lumen loss (LLL), binary restenosis (BR), myocardial infarction (MI), target lesion revascularization (TLR) and mortality.ResultsTwenty-three trials with a total of 2712 patients were included. There were no significant differences in the primary endpoint of MACE between the DEB and DES groups (Risk Ratio (RR) 1.19; 95% confidence interval (CI) (0.87, 1.63); P = 0.27), or in the clinical outcomes of each of MACE’s components, including TLR, MI and mortality. However, efficacy was significantly different between the DEB and DES groups, especially when we compared DEB to second-generation DES: in-lesion LLL (Mean Difference (MD) 0.11; (0.01, 0.22); P = 0.03); binary restenosis (RR 1.46; (1.00, 2.13); P = 0.05).ConclusionsDEB is equivalent to DES in terms of safety for managing CAD, and DEB may be considered as an alternative choice for treatment of CAD.
Highlights
Drug-eluting balloons (DEB) have significant value for treating coronary artery disease (CAD)
We extracted the number of patients, the types of DEB and drug-eluting stents (DES), follow-up time, dual anti platelet therapy (DAPT) duration, and other information needed for this analysis from each study
The baseline characteristic data between the DEB and DES groups are summarized in Table 1, and more baseline clinical data are summarized in Additional file 2
Summary
Drug-eluting balloons (DEB) have significant value for treating coronary artery disease (CAD). The merits of using DEB versus drug-eluting stents (DES) to treat CAD remain controversial. The clinical application of drug eluting stents (DES) has greatly reduced the occurrence rate of in-stent restenosis (ISR), which is one of the major complications associated with bare metal stents (BMS) [3]. DES is not effective at treating some complex coronary artery lesion subsets, Based on the above-mentioned limitations of DES, DEB was designed to avoid insertion of a permanent foreign object in the blood vessel, and prevent potential problems caused by DES [10]. To circumvent the elastic recoil that occurs after DEB inflation, a bare metal stent (BMS) is subsequently employed [14]
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