Drug-coated balloons in coronary disease: meta-analysis comparing sirolimus- and paclitaxel-coated technologies
9 affiliations
- 1Internal Medicine Trainee, University Hospitals Birmingham
- 2ACCS IM Trainee, Newcastle Upon Tyne
- 3Cardiology Registrar, Ninewells Hospital
- 4Acute Medicine, University Hospitals of Birmingham
- 5Department of Diagnostic Radiology, Menofia University Hospital
- 6Faculty of Pharmacy, Tanta University
- 7Teaching assistant of medical biochemistry and molecular biology - Faculty of Medicine, Benha University
- 8Faculty of Clinical Pharmacy, Tanta University
- 9Faculty of Medicine, Benha University
Abstract
Background and aim Drug-coated balloons (DCBs) are a key alternative to drug-eluting stents for coronary artery interventions, offering the advantage of drug delivery without permanent implants. Both paclitaxel-coated balloons (PCBs) and sirolimus-coated balloons (SCBs) are valuable treatment options. This systematic review and meta-analysis compare the efficacy and safety of sirolimus-coated versus paclitaxel-coated balloon catheters in patients with coronary artery disease. Methods We conducted a systematic review and meta-analysis following PRISMA guidelines, searching five databases. We exclusively included RCTs. Risk ratios (RR) and mean differences (MD) with 95% confidence intervals were calculated using fixed-effects or random-effects models, with sensitivity analysis performed in cases of heterogeneity. Results Eight trials involving 1043 patients were included. The meta-analysis demonstrated no significant difference between SCB and PCB for late lumen loss (MD 0.06, 95% CI [-0.02 to 0.14]). Only two outcomes showed statistically significant differences favoring PCB: reducing late lumen enlargement (RR 0.66, 95% CI [0.49–0.87], P = 0.004) and, after sensitivity analysis, lowering binary restenosis rates in de novo lesions Conclusion This meta-analysis shows SCB and PCB have similar safety and efficacy in coronary artery interventions, with no significant differences in most outcomes. However, PCB outperforms late lumen enlargement and binary restenosis rates in de novo lesions. Similar outcomes across sirolimus formulations indicate other factors influence success. Both balloon types appear safe and effective, though PCB may retain certain advantages in specific scenarios. Larger, longer-term studies are needed to establish the optimal drug-coated balloon strategy for different patient populations. Clinical trial number: not applicable.
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BibTeX
@article{ibraheem2026drugcoated,
title = {{Drug-coated balloons in coronary disease: meta-analysis comparing sirolimus- and paclitaxel-coated technologies}},
author = {Mohammedrashid Ibraheem and Aly Abouslima and Ahmed Ebrahim and Salma Ahmed and Sara E. Elbahnasawy and Mohamed Hesham Gamal and Nada Ramadan and Manar Adel and Mahmoud M. Elhady},
journal = {BMC Cardiovascular Disorders},
year = {2026},
month = oct,
doi = {10.1186/s12872-026-06811-8},
url = {https://doi.org/10.1186/s12872-026-06811-8},
note = {CC BY},
}
RIS
TY - JOUR
TI - Drug-coated balloons in coronary disease: meta-analysis comparing sirolimus- and paclitaxel-coated technologies
AU - Mohammedrashid Ibraheem
AU - Aly Abouslima
AU - Ahmed Ebrahim
AU - Salma Ahmed
AU - Sara E. Elbahnasawy
AU - Mohamed Hesham Gamal
AU - Nada Ramadan
AU - Manar Adel
AU - Mahmoud M. Elhady
PY - 2026
DA - 2026/10/25
JO - BMC Cardiovascular Disorders
DO - 10.1186/s12872-026-06811-8
UR - https://doi.org/10.1186/s12872-026-06811-8
AB - Background and aim Drug-coated balloons (DCBs) are a key alternative to drug-eluting stents for coronary artery interventions, offering the advantage of drug delivery without permanent implants. Both paclitaxel-coated balloons (PCBs) and sirolimus-coated balloons (SCBs) are valuable treatment options. This systematic review and meta-analysis compare the efficacy and safety of sirolimus-coated versus paclitaxel-coated balloon catheters in patients with coronary artery disease. Methods We conducted a systematic review and meta-analysis following PRISMA guidelines, searching five databases. We exclusively included RCTs. Risk ratios (RR) and mean differences (MD) with 95% confidence intervals were calculated using fixed-effects or random-effects models, with sensitivity analysis performed in cases of heterogeneity. Results Eight trials involving 1043 patients were included. The meta-analysis demonstrated no significant difference between SCB and PCB for late lumen loss (MD 0.06, 95% CI [-0.02 to 0.14]). Only two outcomes showed statistically significant differences favoring PCB: reducing late lumen enlargement (RR 0.66, 95% CI [0.49–0.87], P = 0.004) and, after sensitivity analysis, lowering binary restenosis rates in de novo lesions Conclusion This meta-analysis shows SCB and PCB have similar safety and efficacy in coronary artery interventions, with no significant differences in most outcomes. However, PCB outperforms late lumen enlargement and binary restenosis rates in de novo lesions. Similar outcomes across sirolimus formulations indicate other factors influence success. Both balloon types appear safe and effective, though PCB may retain certain advantages in specific scenarios. Larger, longer-term studies are needed to establish the optimal drug-coated balloon strategy for different patient populations. Clinical trial number: not applicable.
SN - 1471-2261
ER -