Scoring balloon versus drug-eluting balloon in coronary intervention for very small coronary vessels

Background: The optimal therapeutic strategy for coronary intervention in very small coronary vessels (<2.5 mm.) remains controversial and challenging. Objective: The aim of this study is to assess the 12 months outcome of scoring balloon (SB) versus drug-eluting balloon (DEB) in very small (<2.5 mm) coronary interventions. Patients and Methods: Seventy-seven patients referred for coronary intervention with reference vessel diameter <2.5 mm were assigned to either SB or DEB. The primary endpoint was target vessel revascularization (TVR) at 12 months follow-up. Results: Out of 77 patients enrolled, 37.7% were assigned to SB, while 62.3% were assigned to DEB. Sever dissection rate was significantly higher among the DEB group (0% vs. 12.5%, P = 0.048); while TVR rate was significantly lower among the SB group (0% vs. 12.5%, P = 0.048). Similarly, the target vessel-related myocardial infarction rate was significantly lower among the SB group (0% vs. 12.5%, P = 0.048). On the other hand, there were no significant differences in the rates of deaths or restenosis between the two groups. Conclusion and Recommendations: SB is superior to the DEB with better both safety and efficacy for coronary intervention in very small coronary vessels (<2.5 mm). Larger scaled prospective multicenter randomized trials are needed for confirming our favorable results of using SB for coronary intervention in very small coronary vessels <2.5 mm.