{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T05:24:16Z","timestamp":1787203456456,"version":"build-2736575974"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In small, tortuous coronary lesions, the long\u2010term comparative performance of drug\u2010coated balloon (DCB) angioplasty versus drug\u2010eluting stent (DES) treatment remains uncertain, despite both strategies being widely used in contemporary percutaneous coronary intervention (PCI) practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study aimed to compare 3\u2010year clinical outcomes between DES and DCB in patients undergoing PCI for small, tortuous coronary lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective, single\u2010center study included 366 patients treated with either DES (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009226) or DCB (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009140) for lesions with at least one angulation \u2265\u200945\u00b0. The primary endpoint was major adverse cardiac events (MACE). Time\u2010to\u2010event outcomes were assessed using Kaplan\u2013Meier analysis and Cox proportional hazards models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Procedural success rates were high and comparable between groups. At 3 years, MACE occurred more frequently in the DCB group than in the DES group (log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013). In multivariable analysis, DCB use remained associated with higher risks of MACE (hazard ratio [HR] 1.88; 95% confidence interval [CI] 1.12\u20133.16;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.017) and target vessel revascularization (TVR) (HR 1.84; 95% CI 1.01\u20133.21;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045). Subgroup analysis showed that DES had significantly better outcomes than DCB in lesions with mild\u2010to\u2010moderate tortuosity, whereas event rates were similar between groups in severely tortuous segments.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In small, tortuous coronary lesions, DES use was associated with lower rates of MACE and TVR at 3 years than DCB use. The advantage of DES was most apparent in mild\u2010to\u2010moderate tortuosity, whereas it was not statistically significant in severely tortuous vessels. These findings highlight the importance of anatomic complexity when selecting a treatment strategy for tortuous coronary lesions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70814","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T04:43:43Z","timestamp":1787201023000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Outcomes of Drug\u2010Eluting Stents and Drug\u2010Coated Balloons in Tortuous Small Coronary Lesions"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6788-6803","authenticated-orcid":false,"given":"Shunichiro","family":"Ishio","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Gunma University Graduate School of Medicine Gunma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3565-7099","authenticated-orcid":false,"given":"Takashi","family":"Nagasaka","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Gunma University Graduate School of Medicine Gunma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2356-776X","authenticated-orcid":false,"given":"Ryota","family":"Taniuchi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Gunma University Graduate School of Medicine Gunma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9991-1911","authenticated-orcid":false,"given":"Shiro","family":"Amanai","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Gunma University Graduate School of Medicine Gunma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3295-2765","authenticated-orcid":false,"given":"Yohei","family":"Ishibashi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Gunma University Graduate School of Medicine Gunma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0226-8142","authenticated-orcid":false,"given":"Noriaki","family":"Takama","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Gunma University Graduate School of Medicine Gunma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4348-0123","authenticated-orcid":false,"given":"Hideki","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Gunma University Graduate School of Medicine Gunma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1056\/NEJMoa035071","article-title":"Sirolimus\u2010Eluting Stents Versus Standard Stents in Patients With Stenosis in a Native Coronary Artery","volume":"349","author":"Moses J. 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