Cutting vs standard balloon for lesion preparation in drug-coated balloon-only PCI: the NATURE randomised trial.
Cardiovasc Interv TherAug 25, 2026 (epub)
Taku Asano, Masafumi Ono, Norihiro Kogame et al.
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In 30 seconds
The NATURE trial, a multicenter randomized study involving 201 patients with de novo coronary lesions, compared cutting balloon (CB) to standard balloon (SB) predilatation for drug-coated balloon (DCB)-only PCI. While optimal lesion preparation was achieved in 35.6% of the CB group versus 30.0% in the SB group (p = 0.28), CB showed lower residual diameter stenosis and less acute recoil, indicating modest angiographic advantages.
Key findings
- Optimal lesion preparation was achieved in 35.6% of the CB group vs 30.0% of the SB group (p = 0.28).
- CB predilatation resulted in lower residual diameter stenosis (30.8 ± 11.8% vs 34.5 ± 13.3%; p = 0.04).
- CB showed less acute recoil (1.18 ± 0.36 mm vs 1.31 ± 0.50 mm; p = 0.03).
- Trends towards larger lumen dimensions on IVUS were observed with CB.
Why it matters
Optimal lesion preparation is crucial for the success of DCB therapy, as DCBs lack mechanical support. Understanding the comparative effectiveness of CB and SB can inform clinical decisions in PCI procedures.