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Page 4 of 12 Onea et al. Vessel Plus 2023;7:13 https://dx.doi.org/10.20517/2574-1209.2023.11

Figure 1. Cutoff values of stent length for different DES to predict future adverse events [20] . Bi-BES: Biomatrix biodegradable-
polymer biolimus-eluting stents; CoCr-EES: cobalt-chromium everolimus-eluting stents; DES: drug-eluting stents; No-BES: Nobori
biodegradable-polymer biolimus-eluting stents; Pr-CoCr-EES: Xience Prime cobalt-chromium everolimus-eluting stents; PtCr-
EES: platinum chromium everolimus-eluting stents; Re-ZES: resolute zotarolimus-eluting stents; SES: sirolimus-eluting stents.

most everolimus- and zotarolimus-DES, while biodegradable-polymer biolimus-DES performance was
subpar. Of note, the combination of long and small diameter stents had the worse outcome, irrespective of
[20]
the technology used .
Extended long-term follow-up on available DES shows an increased frequency of adverse events when using
overlap stenting . A recent meta-analysis including mainly observational studies indicates that using single
[21]
very-long stents when tackling diffuse lesions can be associated with higher rates of cardiac death and TLR
(RR: 1.51, CI: 1.03 - 2.21; RR: 1.64, CI: 1.02 - 2.65) .
[22]

DRUG-COATED BALLOON USE IN NATIVE VESSELS
Small coronary native vessels disease
Three pivotal studies that investigated the use of DCB in de-novo small coronary vessels have recently
reported long-term follow-up results.

The RESTORE SVD trial enrolled 230 patients with reference vessel diameter (RVD) ranging between 2.25
and 2.75 mm, which were randomized to the Restore paclitaxel-DCB (Eurocor, Germany) or the
RESOLUTE Integrity DES in a 1:1 ratio. During TCT 2022, Shao-Liang Chen reported the 5-year follow-up
results and the TLF rates between the groups were similar (8.0% vs. 7.3%; P = 0.85), while no
device thrombosis was described.

BASKET-SMALL 2 trial compared SeQuent Please DCB (B. Braun, Germany) vs. DES (75% EES, 25%
paclitaxel-DES) in terms of MACE and all-cause death in patients with RVD ranging between 2 and 3 mm.
At the 3-year follow-up, no significant differences between the groups were found (MACE was 15% in both