Meta-analysis of efficacy of drug-coated balloon versus non-drug balloon for side branch protection in interventional treatment of bifurcation lesions

Pang Xuyao; Zhao Shixia; Liu Litian; Zhang Feifei

doi:10.26939/j.cnki.CN11-9353/R.2025.10.004

Abstract：Objective To explore and evaluate the efficacy of drug-coated balloon(DCB)versus non-drug-coated balloon(NDCB)in side branch protection during coronary intervention.Methods Databases including PubMed,Embase,Cochrane Library,Web of Science,China National Knowledge Infrastructure(CNKI),Wanfang Database,and Chinese Biomedical Literature Database(CBM)were searched,and relevant cardiovascular professional websites were also reviewed.The retrieval time was from the establishment of each database to June 2024 for relevant clinical studies.Literatures were screened according to the inclusion and exclusion criteria.Randomized controlled studies were evaluated using the Cochrane Risk of Bias Tool,and non-randomized controlled studies were evaluated using the Newcastle-Ottawa Scale.Relevant data were extracted,and statistical analysis was performed using RevMan 5.3.Results A total of 10 articles were included,among which 4 were randomized controlled studies and 6 were non-randomized controlled studies,with a total of 1 720 cases.The results of meta-analysis showed that compared with the NDCB group,the DCB group had lower late luminal loss of side branch vessels(MD=-0.17,95%CI:-0.26--0.08,P<0.01),while there were no statistically significant differences in target lesion revascularization(TLR),non-fatal myocardial infarction,and major adverse cardiovascular events(MACE).Subgroup analysis of non-randomized controlled studies showed that compared with the NDCB group,the DCB group was superior in terms of late luminal loss of side branch vessels(MD=-0.20,95%CI:-0.31--0.09,P<0.01),TLR(OR=0.44,95%CI:0.24-0.81,P<0.01),and MACE(OR=0.47,95%CI:0.27-0.79,P<0.01).Conclusion In the interventional treatment of primary coronary bifurcation lesions,compared with NDCB,DCB may improve late luminal loss and reduce the incidence of TLR and MACE.However,more large-sample randomized controlled studies are still needed for verification.