OUTCOME OF DRUG-ELUTING BALLOON (DEB) VERSUS DRUG-ELUTING STENT IN PATIENTS WITH ACUTE STENT THROMBOSIS
Main Article Content
Keywords
Drug-eluting stent, Drug-eluting balloon, Acute stent thrombosis, Coronary intervention, clinical outcomes, Reliability, Pearson correlation.
Abstract
Background: Percutaneous coronary intervention represents an acute effect of stent thrombosis, still life-threatening. There is minimal data on clinical outcomes of drug-eluting stents (DES) and drug-eluting balloons (DEB) used in revascularization, although both can be used in acute thrombosis. This study had a vision of comparing and contrasting the outcomes of procedural and short-term outcomes in a patient presenting with acute stent thrombosis and comparing them with the outcomes of a DEB and DES intervention.
Methods: It was A quantitative cross-sectional study was conducted on 319 patients who were measured angiographically across acute stent thrombosis. Data was collected in the form of a questionnaire that was made valid and contained 42 items. The scale was very reliable (Cronbach 1=0.921) and internally valid in terms of construct validity (KMO=.813; p<0.001). Normality (Shapiro =Wilk test), independent samples t-test, one-way ANOVA, Kruskal-Wallis, Chi-square, Pearson correlation, and multiple regression test were examined and identified through the use of the SPSS v26 and the SmartPLS 4.0 statistical packages that identify statistical t -t-tests.
Results: The internal consistency of all the variables was also good because there was no important difference (p > 0.05) in their external distribution. The t-test (p 0.009; www.pivotize.com ) and ANOVA ( p 0.006; www.pivotize.com ) yielded significant differences in the results of the DEB and DES that presented a statistically significant effect on the procedural success of these two modalities and the long-term vessel patency, which were in favor of DES. Both the Kruskal-Wallis (p = 0.015) and Chi-square (p = 0.012) tests, which used no parameters, and the categorical tests were used to compare these differences. Pearson correlation coefficients were positive and strong (r = 0.60 -0.97, p = 0.006), and regression indicated that Intervention Type (B = 0.142, p = 0.006) and Age (B = 0.011, p = 0.014) had a stronger prediction with the outcome of having good results (R 2 = 0.384).
Conclusion: The article arrives at the conclusion that the outcome of DES intervention is significantly more positive when compared to the results of a reluctant attempt in the treatment of acute stent thrombosis patients by DEB. The findings are credible because of the high validity and reliability of the instrument. DES is the most preferable type of therapeutic modality as this type is considered superior in terms of its patency, effectiveness, and longevity. The available research should take into account hybrids and new drug-coating ideas that would assist in capitalizing on patient-customized treatment options.
References
2. Caminiti, R., Vizzari, G., Ielasi, A., Vetta, G., Parlavecchio, A., Della Rocca, D. G., Montonati, C., Pellegrini, D., Pellicano, M., & Tespili, M. (2025). Drug-coated balloon versus drug-eluting stent for treating de novo large vessel coronary artery disease: a systematic review and meta-analysis of 13 studies involving 2888 patients. Clinical Research in Cardiology, 114(8), 978-990.
3. Elgendy, I. Y., Mahmoud, A. N., Elgendy, A. Y., Mojadidi, M. K., Elbadawi, A., Eshtehardi, P., Pérez-Vizcayno, M. J., Wayangankar, S. A., Jneid, H., & Anderson, R. D. (2019). Drug-eluting balloons versus everolimus-eluting stents for in-stent restenosis: a meta-analysis of randomized trials. Cardiovascular Revascularization Medicine, 20(7), 612-618.
4. Gao, L., Wang, Y.-B., Jing, J., Zhang, M., & Chen, Y.-D. (2019). Drug-eluting balloons versus new generation drug-eluting stents for the management of in-stent restenosis: an updated meta-analysis of randomized studies. Journal of Geriatric Cardiology: JGC, 16(6), 448.
5. Gao, R., Guo, L., Liu, J., Yao, T., Liu, G., Guan, Z., & Ma, J. (2025). Evaluation of the effectiveness and safety of preoperative drug elution balloon therapy in patients with elective tumor surgery and coronary heart disease: a retrospective clinical study: The best choice of PCI for patients with elective tumor surgery and CHD. BMC Cardiovascular Disorders, 25(1), 171.
6. Hassan, A., Mansour, A., Elkasaby, M. H., Ramadan, S., Nabil, A., Suwannasom, P., Saad, M., de Winter, R. J., Hemetsberger, R., & Abdelghani, M. (2025). Drug‐Coated Balloon Versus Drug‐Eluting Stent for De Novo Lesions of Large Coronary Arteries: A Systematic Review and Meta‐Analysis of Angiographic and Clinical Outcomes. Catheterization and Cardiovascular Interventions.
7. Januszek, R., Bil, J., Gilis-Malinowska, N., Staszczak, B., Figatowski, T., Milewski, M., Mielczarek, M., Dylewski, Ł., Wybraniec, M., & Tomasiewicz, B. (2022). Long-term outcomes following drug-eluting balloon or thin-strut drug-eluting stents for treatment of in-stent restenosis stratified by duration of dual antiplatelet therapy (DEB-Dragon Registry). Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 18(1), 14-26.
8. Kayssi, A., Al‐Jundi, W., Papia, G., Kucey, D. S., Forbes, T., Rajan, D. K., Neville, R., & Dueck, A. D. (2019). Drug‐eluting balloon angioplasty versus uncoated balloon angioplasty for the treatment of in‐stent restenosis of the femoropopliteal arteries. Cochrane Database of Systematic Reviews(1).
9. Kim, M. S., Park, S. H., Oh, S., Hyun, D. Y., Lee, S. H., Lim, Y. H., Ahn, J. H., Cho, K. H., Kim, M. C., & Sim, D. S. (2024). Comparison of Clinical Outcomes between Drug-Eluting Balloons and Drug-Eluting Stents in Patients with Small Coronary Artery Disease. The Korean Journal of Medicine, 99(5), 253-262.
10. Li, L., Xu, Z.-W., & Qiu, R.-R. (2025). Drug-Eluting Balloons Versus Conventional Balloons in Treatment of Coronary Bifurcation Lesions in Small Vessels. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 31, e948370.
11. Lin, Y., Sun, X., Liu, H., Pang, X., & Dong, S. (2021). Drug-coated balloon versus drug-eluting stent for treating de novo coronary lesions in large vessels: a meta-analysis of clinical trials. Herz, 46(3), 269-276.
12. Mahajan, N., Singal, G., & Sharma, M. (2025). Comparative outcomes of drug-eluting stents and drug-eluting balloons in treating in-stent restenosis. Archives of Medical Science–Atherosclerotic Diseases, 10(1), 167-171.
13. Mangner, N., Farah, A., Ohlow, M.-A., Möbius-Winkler, S., Weilenmann, D., Wöhrle, J., Linke, A., Stachel, G., Markovic, S., & Leibundgut, G. (2022). Safety and efficacy of drug-coated balloons versus drug-eluting stents in acute coronary syndromes: a prespecified analysis of BASKET-SMALL 2. Circulation: Cardiovascular Interventions, 15(2), e011325.
14. Megaly, M., Buda, K., Saad, M., Tawadros, M., Elbadawi, A., Basir, M., Abbott, J. D., Rinfret, S., Alaswad, K., & Brilakis, E. S. (2022). Outcomes with drug-coated balloons vs. drug-eluting stents in small-vessel coronary artery disease. Cardiovascular Revascularization Medicine, 35, 76-82.
15. Megaly, M., Buda, K. G., Xenogiannis, I., Vemmou, E., Nikolakopoulos, I., Saad, M., Rinfret, S., Abbott, J. D., Aronow, H. D., & Garcia, S. (2021). Systematic review and meta-analysis of short-term outcomes with drug-coated balloons vs. stenting in acute myocardial infarction. Cardiovascular Intervention and Therapeutics, 36(4), 481-489.
16. Mizutani, Y., Ishikawa, T., Nakamura, H., Yamada, K., Shimura, M., Kondo, Y., Ukaji, T., Aoki, H., Hisauchi, I., & Itabashi, Y. (2022). A Propensity Score-Matched Comparison of Midterm Outcomes Between Drug-Coated Balloons and Drug-Eluting Stents for Patients with Acute Coronary Syndrome: A Single-Center Study. International Heart Journal, 63(2), 217-225.
17. Murphy, G., Naughton, A., Durand, R., Heron, E., McCaughey, C., Murphy, R. T., & Pearson, I. (2023). Long-term outcomes for drug-eluting balloons versus drug-eluting stents in the treatment of small vessel coronary artery disease: a systematic review and meta-analysis. Interventional Cardiology: Reviews, Research, Resources, 18, e14.
18. Natarajan, R., Corballis, N., Merinopoulos, I., Tsampasian, V., Vassiliou, V. S., & Eccleshall, S. C. (2025). A systematic review and meta-analysis of the use of drug-coated balloon angioplasty for treatment of both de novo and in-stent coronary chronic total occlusions. Clinical Research in Cardiology, 1-15.
19. Rivero-Santana, B., Jurado-Roman, A., Galeote, G., Jimenez-Valero, S., Gonzalvez, A., Tebar, D., & Moreno, R. (2024). Drug-Eluting Balloons in Calcified Coronary Lesions: A Meta-Analysis of Clinical and Angiographic Outcomes. Journal of Clinical Medicine, 13(10), 2779.
20. Sawar, S., Ali, N., Ullah, R., Khakwani, F., & Khan, M. (2025). Outcomes of Drug-Eluting Balloon-Only Percutaneous Coronary Intervention in Elderly Patients With Acute Coronary Syndrome and High Bleeding Risk. Cureus, 17(6).
21. Shabeer, H., Sattar, S., Arti, F., Kumar, H., Iltaf, K., Zaryab Haider, M., Haq Saqib, B. U., Hassan Bari, M., Karim, A., & Kumar, S. (2025). Comparative Outcomes of Drug‐Eluting Balloons Versus Drug‐Eluting Stents in Patients With Diabetes Undergoing PPCI. Catheterization and Cardiovascular Interventions.
22. Siahaan, H., Notobroto, H. B., Oktaviono, Y. H., Siahaan, P. P., Budi, D. S., & Anjaswanti, R. N. (2025). Optimizing stent restenosis management: A meta-analysis of new generation drug-eluting stent versus drug-eluting balloon in small vessels. Journal of Pharmacy and Pharmacognosy Research, 13(5), 1327-1337.
23. Song, C.-x., Zhou, C., Hou, W., Yin, Y., Lu, S., Liu, G., Duan, C., Li, M., & Zhang, H. (2020). Drug-eluting balloons versus drug-eluting stents for small vessel coronary artery disease: a meta-analysis. Coronary Artery Disease, 31(3), 199-205.
24. Spaulding, C., Krackhardt, F., Bogaerts, K., Urban, P., Meis, S., Morice, M.-C., & Eccleshall, S. (2023). Comparing a strategy of sirolimus-eluting balloon treatment to drug-eluting stent implantation in de novo coronary lesions in all-comers: Design and rationale of the SELUTION DeNovo Trial. American Heart Journal, 258, 77-84.
25. Su, H., Li, M., Hao, L., & Wang, H. (2022). Comparison of Drug-Coated Balloons and Drug-Eluting Stents in Primary Percutaneous Coronary Interventions for ST-Segment Elevated Myocardial Infarction: A Systematic Review and Meta-Analysis. Reviews in Cardiovascular Medicine, 23(6), 203.
26. Tan, Q., Wang, Q., Yang, H., Jing, Z., & Ming, C. (2021). Clinical outcomes of drug-eluting balloon for treatment of small coronary arteries in patients with acute myocardial infarction. Internal and Emergency Medicine, 16(4), 913-918.
27. Vos, N. S., Fagel, N. D., Amoroso, G., Herrman, J.-P. R., Patterson, M. S., Piers, L. H., van der Schaaf, R. J., Slagboom, T., & Vink, M. A. (2019). Paclitaxel-coated balloon angioplasty versus drug-eluting stent in acute myocardial infarction: the REVELATION randomized trial. JACC: Cardiovascular Interventions, 12(17), 1691-1699.
28. Wang, G., Zhao, Q., Chen, Q., Zhang, X., Tian, L., & Zhang, X. (2019). Comparison of drug-eluting balloon with repeat drug-eluting stent for recurrent drug-eluting stent in-stent restenosis. Coronary Artery Disease, 30(7), 473-480.
29. Wolny, R., Kowalik, I., Januszek, R., Bil, J., Figatowski, T., Milewski, M., Tomasiewicz, B., Walczak, T., Hrymniak, B., & Desperak, P. (2022). Long-term outcomes following drug-eluting balloons vs. thin-strut drug-eluting stents for treatment of recurrent restenosis in drug-eluting stents. Polish Heart Journal (Kardiologia Polska), 80(7-8), 765-773.
30. Yang, Y.-X., He, K.-Z., Li, J.-Y., Fu, Y., Li, C., Liu, X.-M., Wang, H.-J., Chen, M.-L., Su, P.-X., & Xu, L. (2023). Comparisons of drug-eluting balloon versus drug-eluting stent in the treatment of young patients with acute myocardial infarction. Journal of Cardiovascular Development and Disease, 10(1), 29.
31. Yang, Y.-X., Liu, Y., Li, C.-P., Lu, P.-J., Wang, J., & Gao, J. (2020). Clinical Outcomes of Drug‐Eluting versus Bare‐Metal In‐Stent Restenosis after the Treatment of Drug‐Eluting Stent or Drug‐Eluting Balloon: A Systematic Review and Meta‐Analysis. Journal of Interventional Cardiology, 2020(1), 8179849.
32. Zeng, J., Liu, Y., Zhao, T., Yuan, J., Yang, W., & Wang, M. (2025). Drug-Coated Balloons Versus Drug-Eluting Stents for Large Vessel Coronary Artery Disease: A Meta-Analysis. Journal of Cardiovascular Development and Disease, 12(9), 359.
33. Zhang, D.-P., Wang, L.-F., Liu, Y., Li, K.-B., Xu, L., Li, W.-M., Ni, Z.-H., Xia, K., Zhang, Z.-Y., & Yang, X.-C. (2020). Efficacy comparison of primary percutaneous coronary intervention by drug-coated balloon angioplasty or drug-eluting stenting in acute myocardial infarction patients with de novo coronary lesions. Zhonghua xin xue Guan Bing za zhi, 48(7), 600-607.
34. Zhao, K., Guo, Q., Zhao, Z., Tang, H., You, R., Peng, L., Rao, L., & Li, M. (2024). Clinical value of drug-coated balloon versus second-generation drug-eluting stent for de novo lesions in large coronary arteries: insights from the real world. BMC Cardiovascular Disorders, 24(1), 697.
35. Zhu, Y., Liu, K., Kong, X., Nan, J., Gao, A., Liu, Y., Han, H., Li, H., Zhu, H., & Zhang, J. (2021). Comparison of drug-coated balloon angioplasty vs. drug-eluting stent implantation for drug-eluting stent restenosis in the routine clinical practice: a meta-analysis of randomized controlled trials. Frontiers in Cardiovascular Medicine, 8, 766088.
36. Ziyad, M., Shah, S. T., Rauf, M. A., Shah, S. M., Ullah, S., Ullah, R., Khan, M. I., & Rauf, M. (2025). Evaluating Drug-Eluting Balloons Versus Stenting for Provisional Bifurcation Lesions: Short-Term Outcomes and Future Directions. Cureus, 17(2).
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Muhammad Ahmad Raza Butt
Associate Professor, Rashid Latif Medical College, Lahore, Punjab
Safi Ullah
FCPS Cardiology, Lady Reading Hospital Peshawar, KPK
Faisal Ahmed
FCPS Cardiology, Assistant Professor, Department of Cardiology, Hamdard University Hospital
Sher Muhammad
Assistant Professor, Department of Cardiology, Karachi Institute of Medical Sciences
Khalid Hussain Soomro
Assistant Professor Interventional Cardiologist, Department of Cardiology, Pir Abdul Qadir Shah Jeelani Institute of Medical Science Gambat Khairpur Mirs, Sindh
Tahira Jehangir
Associate Professor / Chairman, Pharmacology Department, Nowshera Medical College
