Drug-coated balloons versus drug-eluting stents for de novo ostial left circumflex lesions: the international multicenter DCB-CIRCO registry
Abstract
Background: Percutaneous coronary intervention (PCI) with drug-eluting stents (DES) on ostial left circumflex (oLCx) is associated with a high rate of adverse events.
Aims: This study aims to compare drug-coated balloons (DCB) and DES in the treatment of oLCx lesions.
Background: Percutaneous coronary intervention (PCI) with drug-eluting stents (DES) on ostial left circumflex (oLCx) is associated with a high rate of adverse events.
Aims: This study aims to compare drug-coated balloons (DCB) and DES in the treatment of oLCx lesions.
Methods: Consecutive patients undergoing DCB-PCI of de novo oLCx lesions (isolated or in the context of a distal left main bifurcation) in eight international centers from 2018 to 2023 were retrospectively enrolled and compared with a historical cohort of patients who received PCI with DES. The primary endpoint was the 2-year incidence of target lesion failure (TLF), a composite of target lesion revascularization (TLR), target vessel-myocardial infarction and cardiac death, at time-to-first event analysis. Propensity-score matching was adopted to adjust for clinical and angiographic confounders.
Results: A total of 152 patients were included in the DCB group and 351 patients in the DES group. Patients in the DES group had more multivessel disease (94.6% vs. 82.7%, p < 0.001) but shorter lesions (18.0 [interquartile range, IQR: 15.0-28.0] vs. 25.5 [17.4-40.0] mm, p < 0.001) than those in the DCB group. Fluoroscopy time (20.0 [IQR: 14.0-28.2] vs. 31.0 [21.0-45.5] min, p < 0.001) and amount of contrast used (150 [IQR: 120-220] vs. 200 [140-250] mL, p = 0.006) were significantly lower in DCB-PCI than DES-PCI. The 2-year rate of TLF was similar in the two groups (19.0% in the DCB group vs. 19.8% in the DES group, hazard ratio [HR]: 1.05, 95% confidence interval [CI] 0.64-1.75). This result remained consistent in the 126 pairs of patients obtained after propensity score matching.
Conclusions: In a multinational observational retrospective real-world study including patients undergoing PCI on oLCx, no difference in TLF rate was detected between PCI with DCB and PCI with DES at a midterm follow-up.
Author
Tartaglia, Francesco
Basavarajaiah, Sandeep
Gitto, Mauro
Cozzi, Ottavia F
Knobel, Leoni
Stutz, Leah
Tran, Quan
Loku Waduge, Harindi
Leone, Pier Pasquale
Calamita, Gianmaria
Deepak Bhavnani, Chandan
Maurina, Matteo
Morosato, Michele
Ielasi, Alfonso
Gasparini, Gabriele
Routledge, Helen
Selvaraj, Kamaraj
Testa, Luca
Reimers, Bernhard
Bossard, Matthias
Cuculi, Florim
Regazzoli, Damiano
Stefanini, Giulio G
Mangieri, Antonio
Colombo, Antonio
Basavarajaiah, Sandeep
Gitto, Mauro
Cozzi, Ottavia F
Knobel, Leoni
Stutz, Leah
Tran, Quan
Loku Waduge, Harindi
Leone, Pier Pasquale
Calamita, Gianmaria
Deepak Bhavnani, Chandan
Maurina, Matteo
Morosato, Michele
Ielasi, Alfonso
Gasparini, Gabriele
Routledge, Helen
Selvaraj, Kamaraj
Testa, Luca
Reimers, Bernhard
Bossard, Matthias
Cuculi, Florim
Regazzoli, Damiano
Stefanini, Giulio G
Mangieri, Antonio
Colombo, Antonio
Date
2025-09-05
Type
Article
Subject
Drug-eluting stents, Angioplasty, balloon, Stents, Drug-eluting stents
Collections
Citation
Tartaglia F, Basavarajaiah S, Gitto M, Cozzi OF, Knobel L, Stutz L, Tran Q, Loku Waduge H, Leone PP, Calamita G, Deepak Bhavnani C, Maurina M, Morosato M, Ielasi A, Gasparini G, Routledge H, Selvaraj K, Testa L, Reimers B, Bossard M, Cuculi F, Regazzoli D, Stefanini GG, Mangieri A, Colombo A. Drug-Coated Balloons Versus Drug-Eluting Stents for De Novo Ostial Left Circumflex Lesions: The International Multicenter DCB-CIRCO Registry. Catheter Cardiovasc Interv. 2025 Nov;106(5):2958-2968. doi: 10.1002/ccd.70154. Epub 2025 Sep 5.
Journal / Source Title
Catheterization and Cardiovascular Interventions
DOI
10.1002/ccd.70154
PMID
40910732
Publisher
Wiley-Liss
Publisher’s URL
https://onlinelibrary.wiley.com/journal/1522726x