ReviewEuropean journal of medical research2026
Safety, efficacy, OCT-assessed vascular healing and angiographic outcomes of polymer-free versus biodegradable-polymer drug-eluting stents in patients undergoing percutaneous coronary intervention: a systematic review and meta-analysis.
Review in European journal of medical research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
4 authors.
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Abstract
backgroundBiodegradable polymer (BP) and polymer-free (PF) drug eluting stents were designed to reduce late adverse events linked to durable-polymer coatings. However, concerns remain regarding the efficacy of PF-DES particularly due to variations in drug-release mechanisms.
methodsRCTs comparing PF-DES and BP-DES in patients undergoing percutaneous coronary interventions were included. Primary endpoints were Target lesion revascularization (TLR), Target vessel revascularization (TVR), definite stent thrombosis, Cardiac death (CD), angiographic outcomes and optical coherence tomography (OCT) findings. Risk of bias was assessed using Cochrane's ROB 2.0 and meta-analysis performed using RevMan 5.4.
resultsTen RCTs including 9020 patients (4043 PF-DES; 4977 BP-DES) were included. At 12 months, PF-DES showed a significantly higher TLR rate (2.08% vs. 1.36%; RR 1.55, 95% CI 1.087-2.21; P = 0.02), persisting at 24 months (RR = 2.01, 95% CI 1.46-2.77, P < 0.0001). At 1-3 months, OCT-derived analyses demonstrated no statistically significant differences in uncovered struts or neointimal thickness between stent types, while findings related to malapposed struts were heterogenous and dependant on sensitivity analyses. Angiographically, PF-DES showed greater in-stent late lumen loss at 6-8 months ([MD]: 0.24 mm, 95% CI 0.17-0.30, P < 0.00001), whereas minimal lumen diameter was comparable. However, no significant differences were found in target vessel revascularization (TVR), stent thrombosis, myocardial infarction, or mortality at 1- or 2-year follow-up.
conclusionsPF-DES were associated with comparable safety to BP-DES; however, it exhibited higher rates of target lesion revascularization and greater late lumen loss were observed. OCT-derived findings were heterogenous and should be interpreted cautiously. Further RCTs with standardized imaging protocols and longer follow-up are warranted.
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