Evidence map›Paper›PMID 42329403›Full record

ArticleClinical research in cardiology : official journal of the German Cardiac Society2026

Revascularization with drug-coated balloons alone in complex coronary artery disease: a systematic review.

Michael Kunz, Felix Götzinger, Marnix Tjeerdsma, Alana Korah, Bernardo Cortese, Tuomas T Rissanen, Bruno Scheller, Andrew R Chapman, Felix Mahfoud, Gregor Leibundgut and 1 more

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Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Michael KunzClinic of Cardiology, University Heart Center Basel, University Hospital Basel, University of Basel, Basel, Switzerland. m.kunz@usb.ch.ORCID http://orcid.org/0000-0001-9666-2209
Felix GötzingerClinic of Cardiology, University Heart Center Basel, University Hospital Basel, University of Basel, Basel, Switzerland.
Marnix TjeerdsmaClinic of Cardiology, University Heart Center Basel, University Hospital Basel, University of Basel, Basel, Switzerland.
Alana KorahUniversity of Basel, Basel, Switzerland.
Bernardo CorteseDCB Academy, Milan, Italy.
Tuomas T RissanenHeart Center, North Karelia Central Hospital, University of Eastern Finland, Joensuu Kuopio, Finland.
Bruno SchellerClinical and Experimental Interventional Cardiology, University of Saarland, Homburg, Germany.
Andrew R ChapmanBHF/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
Felix MahfoudClinic of Cardiology, University Heart Center Basel, University Hospital Basel, University of Basel, Basel, Switzerland.
Gregor LeibundgutClinic of Cardiology, University Heart Center Basel, University Hospital Basel, University of Basel, Basel, Switzerland.
Jasper BoeddinghausClinic of Cardiology, University Heart Center Basel, University Hospital Basel, University of Basel, Basel, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDrug-coated balloon (DCB) therapy has emerged as an alternative to stent-based treatment in coronary artery disease (CAD), particularly in patients where a "leave-nothing-behind" approach may be advantageous.

aimsThis systematic review aimed to evaluate the current evidence on DCB-only therapy in complex CAD and at assessing its potential role in clinical practice.

methodsWe performed a systematic review searching PubMed, CENTRAL, SCOPUS, and ICTRP from inception to 24th March 2025 to identify studies investigating a DCB-only strategy in complex CAD, defined as bifurcation and calcified lesions, chronic total occlusions (CTO), three-vessel disease, or left main disease. The main inclusion criteria were (i) studies including patients with complex CAD and (ii) the use of DCB-only therapy as the main treatment strategy. Risk of bias was systematically assessed.

resultsA total of 3120 records were identified. After duplicate removal, screening, and full-text review, 34 studies met our inclusion criteria (32 non-randomized, 2 randomized). Seven studies investigated bifurcation lesions (n = 660), nine evaluated CTOs (n = 870), six assessed calcified lesions (n = 455), and 12 included all-comer cohorts with complex lesions (n = 7079). Most studies were conducted in Asia. Overall, DCB-only therapy showed acceptable outcomes in patients with complex CAD. However, 47% (16/34) of studies lacked a control group and the overall risk of bias was high.

conclusionsDCB-only therapy may be feasible in selected patients with complex CAD, but current evidence remains scarce, heterogeneous, and of limited methodological quality. Randomized controlled trials comparing DCB-only with DES-based strategies in complex CAD are warranted.

Indexed as

Bifurcation lesionsChronic total occlusionComplex coronary artery diseaseDrug-coated balloonOrbital atherectomyRotational atherectomy

Identifiers

PMID42329403

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.