Head-to-head comparison of limus- versus paclitaxel-coated balloons in the treatment of in-stent restenosis: a meta-analysis

Background: There is a lack of robust comparative data between limus drug-coated balloons (DCBs) versus paclitaxel-coated balloons (PCBs) on their efficacy and safety in treating in-stent restenosis (ISR). Aims: The objective of this systematic review and meta-analysis was to compare the efficacy and safety of limus DCBs versus PCBs in terms of clinical and angiographic outcomes during a 12-month follow-up. Methods: Following PRISMA guidelines, we systematically explored PubMed, Scopus, and Cochrane databases up to 20 February 2025 for studies comparing limus DCBs versus PCBs in terms of safety, efficacy, and angiographic outcomes in treating ISR. The primary outcomes were the incidence of clinically driven target lesion revascularisation (TLR) and failure (TLF). Secondary endpoints were major adverse cardiovascular events (MACE) and angiographic findings during follow-up. Results: =27%) analyses. Low heterogeneity was observed across the studies. Conclusions: Our findings suggest that limus DCBs are equally as effective and safe as PCBs for treating ISR, demonstrating non-inferiority in both clinical and angiographic outcomes at 12 months post-intervention.