PCB vs SCB: has the balance begun to shift?

Natarajan, Rajkumar, Chandrasekharan, Karthik and Eccleshall, Simon (2026) PCB vs SCB: has the balance begun to shift? Revista Española de Cardiología (English ed.). ISSN 1885-5857

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Abstract

Paclitaxel-coated balloons (PCB) have long dominated the drug-coated balloon (DCB) landscape, supported by favourable pharmacokinetics and extensive randomised evidence. Sirolimus, by contrast, is inherently less lipophilic and biologically dependent on sustained arterial wall exposure, rendering simple balloon-coating strategies suboptimal. Consequently, early-generation sirolimus- coated balloons (SCB) were met with skepticism regarding effective drug transfer and durable tissue retention. Signals of attenuated late lumen gain with SCB in early randomised comparisons, including the TRANSFORM I, highlighted these limitations. However, subsequent randomised trials in both de novo lesions and in-stent restenosis have failed to demonstrate a meaningful difference in late lumen loss versus PCB.3 Crucially, in contemporary meta-analyses, even when modest angiographic differences are observed, these have not translated into significant differences in clinically relevant outcomes, including target lesion failure, repeat revascularisation, or myocardial infarction.

Item Type:	Article
Uncontrolled Keywords:	drug coated balloon,paclitaxel coated balloon,sirolimus coated balloon,dcb angioplasty,cardiology and cardiovascular medicine,1*,timely and relevant topic,few rcts are currently conducted in this niche area.,editorial material ,/dk/atira/pure/subjectarea/asjc/2700/2705
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	LivePure Connector
Date Deposited:	12 May 2026 13:51
Last Modified:	14 May 2026 15:16
URI:	https://ueaeprints.uea.ac.uk/id/eprint/102964
DOI:	10.24875/RECICE.M26000588

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