Drug-coated balloons rival stents for coronary artery disease

Skip the metal? Drug-coated balloons are holding their own against stents.

A new meta-analysis published in eClinicalMedicine found that drug-coated balloons (DCBs) perform just as well as traditional stents for treating de novo coronary artery disease — even in larger vessels. Researchers analyzed 10 studies involving more than 7,800 patients and found no meaningful difference in cardiovascular death, myocardial infarction, or stent thrombosis between the two approaches.

The findings are significant for patients who'd rather not have a permanent metal implant in their arteries. DCBs also reduce the need for long-term antiplatelet therapy, making them especially appealing for patients at higher bleeding risk. Experts say the results support a more personalized approach — letting patient anatomy, frailty, and preferences guide the choice between balloons and stents.

By the Numbers:

• 10 studies and 7,800+ patients included in the meta-analysis
• No significant difference in CV death, MI, or stent thrombosis between DCBs and stents
• Revascularization rates were higher with balloons when small-vessel-only trials were excluded — though heavily influenced by one trial (REC-CAGEFREE I)

Why it matters: As DCB technology matures and more cardiologists gain experience with the technique, balloons could become a mainstream alternative to stents — giving patients and physicians more flexibility in tailoring treatment to individual needs.