Drug Coated Balloons vs Drug Eluting Stents in De Novo Coronary Stenotic Lesions

Background: While drug-eluting stents (DES) remain the cornerstone of coronary revascularization, their use is associated with notable drawbacks, including restenosis and the requirement for prolonged dual antiplatelet therapy. Drug-coated balloons (DCBs) have emerged as a promising stentless alternative with potential clinical advantages. This investigation aimed to compare the safety and efficacy of DCBs versus DES in treating de novo coronary stenotic lesions in cases with non-ST elevation acute coronary syndromes (NSTACS). Methods: A prospective, randomized controlled trial was conducted on 102 NSTACS cases (51 per group) across two centers. Group I received DCBs, while Group II received DES. Cases were monitored over a 12-month period to evaluate both clinical and angiographic outcomes. Results: The two groups exhibited comparability regarding baseline demographic, clinical, laboratory, or angiographic characteristics (P>0.05). Procedural complications were rare and similar across groups (P=0.556). Restenosis was observed in 3.9% of cases in the DCB in contrast with 2% in the DES (P=1). Major adverse cardiovascular events noticed in 3.9% of DCB-treated cases and 2% of those treated with DES (P=1), with no mortality reported. Conclusion: DCBs represent a safe and effective alternative to DES in managing de novo coronary lesions, particularly in small vessels, with comparable short-term outcomes. Larger-scale studies are recommended to validate long-term benefits and explore broader indications.