Drug-Coated Balloon–Based Angioplasty for Chronic Total Occlusions: The PICCOLETO X Study
Authors' conclusion
In a real-world cohort of patients undergoing CTO PCI, a DCB-based strategy, either alone or in combination with stents, was associated with favorable 1-year clinical outcomes. No significant differences were observed between DCB-only and blended treatment with a stent.
Study context
- Population
- Consecutive chronic total occlusion (CTO) percutaneous coronary intervention (PCI) patients treated with at least 1 drug-coated balloon (DCB) at 21 international centres
- Participants
- 938 patients
- Exposure
- DCB-only vs DCB + stent
- DCB onlyn = 476
- DCB + stentn = 462reference
- Outcome
- Target vessel failure:
- Cardiac death
- Target vessel MI
- Target vessel revascularization
- Follow-up
- 12 months
Methodological detailsmulticentre, ambispective, all-comers, propensity-score matched
- Multicentre
- Ambispective
- All-comers
- Propensity-score matched
Main finding
As reported in the abstract
Target vessel failure
P < 0.399
- Target vessel failure, whole population
- 9.5%
Observational data: associations, not effects.
Further findings
Target vessel failure after propensity score matching · 12 months · matched cohort
P < 0.367
Target vessel failure after propensity score matching · 12 months
- No differences for any component of the composite endpoint
Safety
In-hospital AKI, perforation, periprocedural MI
- AKI
- 3.6%
- Perforations
- 5%
- Periprocedural MI
- 1.8%
- No differences among strategies
Original publication
Drug-Coated Balloon–Based Angioplasty for Chronic Total Occlusions: The PICCOLETO X Study. JACC Cardiovasc Interv. Published 21 May 2026. doi:10.
Summarised from the published abstract; every number is checked against it