Limus-Coated Balloon Versus Paclitaxel-Coated Balloon for Percutaneous Coronary Intervention: Updated Systematic Review and Meta-Analysis.

In 30 seconds

This updated systematic review and random-effects meta-analysis compared limus-coated balloons (LCB) with paclitaxel-coated balloons (PCB) for percutaneous coronary intervention, pooling 10 randomised controlled trials involving 1,463 patients and 1,434 lesions. In data pooled to 12 months, there were no statistically significant differences in target lesion revascularisation (TLR; RR 1.14; 0.83-1.58; p=0.42) or other major clinical outcomes. Angiographic outcomes were also generally comparable, although late lumen loss showed a borderline difference and binary restenosis was numerically higher with LCB.

Key findings

• TLR did not differ significantly between LCB and PCB (RR 1.14; 0.83-1.58; p=0.42).
• Major adverse cardiovascular events were similar (RR 0.98; 95% CI 0.64-1.48; p=0.91).
• Late lumen loss showed a borderline difference (MD 0.10; 95% CI -0.00 to 0.21; p=0.05), while binary restenosis was numerically higher with LCB (RR 1.33; 95% CI 0.87-2.05; p=0.19).

Why it matters

The pooled randomised evidence provides a comparative overview of clinical and angiographic outcomes for two coated-balloon approaches. The absence of statistically significant differences in major clinical endpoints is informative, but does not establish equivalence. The borderline late-lumen-loss result and numerical restenosis difference highlight why angiographic findings and device-specific variation warrant careful interpretation.

What to keep in mind

Follow-up was limited to 12 months, and device heterogeneity and limited follow-up constrain firm conclusions about equivalence, particularly for angiographic endpoints.