Drug-Eluting Stents (DES) vs Drug-Coated Balloons (DCB) in Venous Bypass Grafts at a Tertiary Regional Centre

Oct 17, 2026

Head-to-head outcomes of drug-coated balloon (DCB) versus drug-eluting stent (DES) therapy were reviewed for venous-graft stenosis treated with saphenous vein graft PCI. Patients treated between January 2016 and December 2024 were identified retrospectively, with primary endpoints including all-cause mortality, MACE, and chest-pain presentations at 12 months. Among 11 included patients (8 DCB, 3 DES), DCB led to more chest-pain re-presentations and both groups reported no mortality.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages2

Reading Time5 min

AccessFree to download

Introduction

Methods

Results

Conclusion

Figure 1. Correlation between FFR and RFR Table 1. Prevalence of CMD in concordant and discordant epicardial physiology. | CMD Type (n=110) | Concordant
Cases (n=89) | Discordant Cases (n=21) | | --- | --- | --- | | Structural CMD | 19 (21%) | 6 (29%) | | (CFR ,2.5 & IMR ‡25) | | | | Functional CMD | 50 (56%) | 12 (57%) | | (CFR ,2.5 & IMR ,25) | | | | Isolated IMR | 20 (23%) | 3 (14%) | | (CFR ‡2.5 & IMR ‡25) | | | Values represented as n (%) . Abbreviations: CFR, coronary ﬂow reserve; CMD, coronary microvascular dysfunction; IMR, index of microcirculatory resistance. 935 Drug-Eluting Stents (DES) vs Drug-Coated Balloons (DCB) in Venous Bypass Grafts at a Tertiary Regional Centre J. Ang 1,2,*, D. Hinds 1, S. Mayooran 1, A. Mohammed 1,3, G. Nusca 1, K. Huang 1, J. Srinivasan 1, S. Parajuli 1, U. Ponangi 1 1Townsville University Hospital, Townsville, QLD, Australia 2 University of Tasmania, Hobart, TAS, Australia 3James Cook University, Townsville, QLD, Australia Introduction: The use of DCB is expanding in de novo coronary lesions. DES in grafts is known to have higher restenosis rates than native vessel PCI. We reviewed head-tohead outcomes of DCB and DES interventions in grafts to assess their effectiveness in venous-graft stenosis. Methods: All patients who underwent SVG PCI from January 2016 to December 2024 were identiﬁed retrospectively, and patient characteristics and angiographic data assessed. The primary outcomes were all-cause mortality, MACE, and representations with chest pain at 12 months. Results: Of 21 patients identiﬁed, 11 were included: 8 had DCB and 3 received DES; the remaining had unsuccessful or hybrid interventions (POBA, BMS, both DCB and DES) . Six DCB and all DES interventions were for ACS. This was the second graft intervention for three DCB patients and ﬁve DES patients. The average age was 69.1, with similar co-morbidities: hypertension (87.5% vs. 66.7% respectively), diabetes mellitus Table 2. Univariate and multivariate regression analysis of RFR/FFR discordance predictors. | Variable | Univariable OR (95% CI) | Univariable p-value | Multivariable OR (95% CI) | Multivariable p-value | | --- | --- | --- | --- | --- | | Age | 1.03 (0.99-1.06) | 0.099 | 1.02 (0.98-1.06) | 0.376 | | Male sex | 1.37 (0.70-2.66) | 0.358 | | | | Acute coronary syndrome | 0.71 (0.27-1.91) | 0.502 | | | | Elective | 1.36 (0.51-3.64) | 0.502 | | | | Smoking | 1.82 (0.95-3.49) | 0.073 | 1.59 (0.80-3.18) | 0.187 | | Hypertension | 1.75 (0.90-3.41) | 0.097 | 1.55 (0.73-3.29) | 0.249 | | Diabetes | 1.86 (0.99-3.50) | 0.056 | 1.92 (0.94-3.93) | 0.073 | | Previous PCI | 1.64 (0.83-3.25) | 0.156 | | | | LVEF | 1.15 (0.38-3.51) | 0.808 | | | | CFR | 0.76 (0.63-0.93) | 0.006 | 0.53 (0.32-0.87) | 0.012 | | RRR | 1.01 (0.99-1.01) | 0.299 | | | | IMR | 0.99 (0.96-1.02) | 0.458 | | | | MRR | 0.86 (0.75-0.99) | 0.046 | 1.33 (0.93-1.91) | 0.123 | Abbreviations: CFR, Coronary Flow Reserve; FFR, Fractional Flow Reserve; IMR, Index of Microcirculatory Resistance; LVEF, Left Ventricular Ejection Fraction; MRR, Microvascular Resistance Reserve; PCI, Percutaneous Coronary Intervention; RRR, Resistance Reserve Ratio. [https://doi.org/10.1016/j.hlc.2025.06.950](https://doi.org/10.1016/j.hlc.2025.06.950) (37.5% vs. 66.7% respectively) and current or former smoking history (75% vs. 100% respectively) . Half of grafts on were anastomosed to OM1 and 25% to right-PDA. All received 12 months of DAPT post-PCI, though one DCB patient was non-compliant. While no mortality was observed in both groups, 44.4% of DCB patients represented with chest pain and 11% had a MACE at 12 months. Conclusion: Although more DCB patients were analysed, over 12 months DCB interventions to venous grafts eventuated with more chest pain presentations. RCT data is required in all types of de novo lesions to help guide future revascularisation strategies. [https://doi.org/10.1016/j.hlc.2025.06.951](https://doi.o

FAQs

What primary outcomes were assessed at 12 months in the venous graft PCI review?

All-cause mortality, MACE, and chest-pain representations at 12 months were used as primary outcomes.

How many patients received DCB versus DES, and what was the overall inclusion process?

From 21 identified patients undergoing SVG PCI, 11 were included: 8 received DCB and 3 received DES, with remaining cases excluded due to unsuccessful or hybrid interventions.

What did the 12-month results show regarding chest pain and mortality?

No mortality was observed in either group; however, 44.4% of DCB patients presented with chest pain at 12 months, and 11% experienced MACE.

Oct 17, 2026

Uploaded by Taylor Morgan