Drug-coated balloons comparable to drug-eluting stents when PCI patients have a high bleeding risk

When treating patients at a high bleeding risk (HBR) with percutaneous coronary intervention (PCI), the use of a drug-coated balloon (DCB) appears to be as safe and effective as a current-generation drug-eluting stent (DES), according to new findings published in Circulation: Cardiovascular Interventions.[1]

“The use of drug-coated balloon allows shorter duration of dual antiplatelet therapy compared with drug-eluting stents and may reduce thrombotic risk due to the absence of a permanent implant,” wrote lead author Bruno Scheller, MD, of the department of clinical and experimental interventional cardiology at the University of Saarland in Germany, and colleagues.

The study’s authors noted that data from the BASKET-SMALL 2 trial, originally completed in 2018, had already demonstrated that DCB and DES treatment led to comparable outcomes among patients with small coronary artery disease over a three-year period. However, they added, the impact on HBR patients remains unclear.

The group performed a secondary analysis of the BASKET-SMALL 2 trial that took these HBP patients into consideration. Overall, the study included data from 758 patients with de novo lesions in coronary vessels smaller than 3 mm who underwent PCI. They were randomized to a DCB or a second-generation DES. Twenty percent of patients were classified as HBR, including 17% of DCB patients and 24% of DES patients.

Overall, HBR patients tended to have a higher mean age (71 years old) than the rest of the patient population (67 years old). HBR patients were also more likely to present with diabetes, heart failure or hypertension.