Using Drug Coated Balloon Versus Stenting The side Branch After Its Compromisation During Provisional Stenting Of The Main Branch In Coronary Artery Disease Patients Undergoing Percutaneous Coronary Intervention | ||
| Zagazig University Medical Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 10 November 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/zumj.2025.431008.4243 | ||
| Authors | ||
| Abdelrahman Ahmed Adel1; Diaa El Menshawy1; Mohamed Essam EL-Deen Abdelwahab* 2; Tamer Moustafa1 | ||
| 1Cardiology Department, Faculty of Medicine, Zagazig University, Egypt | ||
| 2cardiology Department - Faculty of Medicine - Zagazig University | ||
| Abstract | ||
| Background: Bifurcation lesions are common during percutaneous coronary intervention (PCI), and provisional stenting of main vessel is the preferred approach. However, side branch (SB) compromisation is a frequent challenge. Conventional two-stent techniques increases metal burden and restenosis risk. An alternative to stents is drug-coated balloon (DCB) therapy, which administers antiproliferative medications straight to the arterial wall, potentially restoring SB patency without additional stenting. So, we aimed to compare the drug coated balloon versus stenting of the side branch after its compromisation during provisional stenting of the main branch in coronary artery disease (CAD) patients undergoing PCI. Methods: This prospective comparative study enrolled patients with CAD undergoing PCI with provisional main branch stenting who developed SB compromisation. Patients were randomized into: Group I treated with DCB and Group II treated with SB stenting. The primary endpoint was angiographic success and SB patency. Procedure duration, contrast use, in-hospital complications, restenosis, and major adverse cardiac events (MACE) at follow-up were secondary endpoint. Results: Both strategies achieved high procedural success. DCB use was associated with shorter procedural time and reduced contrast volume compared to SB stenting. Angiographic follow-up showed comparable SB patency between groups. Restenosis rates and MACE incidence at short-term follow-up were not significantly different, although a trend toward lower restenosis was observed in DCB group. Conclusion: DCB represents an effective and safe alternative to SB stenting following compromisation during provisional main branch PCI. By avoiding an additional stent, DCB reduces metal burden, procedure duration, and contrast use while maintaining comparable clinical outcomes. | ||
| Keywords | ||
| Percutaneous coronary intervention; drug-coated balloon; drug-eluting stent; side branch; bifurcation lesion | ||
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