Drug-Coated Balloons Versus Drug-Eluting Stents for De Novo Ostial Left Circumflex Lesions: The International Multicenter DCB-CIRCO Registry

Aims: This study aims to compare drug-coated balloons (DCB) and DES in the treatment of oLCx lesions. Methods: Consecutive patients undergoing DCB-PCI of de novo oLCx lesions (isolated or in the context of a distal left main bifurcation) in eight international centers from 2018 to 2023 were retrospectively enrolled and compared with a historical cohort of patients who received PCI with DES. Results: A total of 152 patients were included in the DCB group and 351 patients in the DES group. Patients in the DES group had more multivessel disease (94.6% vs. 82.7%, p < 0.001) but shorter lesions (18.0 [interquartile range, IQR: 15.0-28.0] vs. 25.5 [17.4-40.0] mm, p < 0.001) than those in the DCB group. Fluoroscopy time (20.0 [IQR: 14.0-28.2] vs. 31.0 [21.0-45.5] min, p < 0.001) and amount of contrast used (150 [IQR: 120-220] vs. 200 [140-250] mL, p = 0.006) were significantly lower in DCB-PCI than DES-PCI. Conclusions: In a multinational observational retrospective real-world study including patients undergoing PCI on oLCx, no difference in TLF rate was detected between PCI with DCB and PCI with DES at a midterm follow-up.