Comparison Of One-Year Outcome After Elective Percutaneous Coronary Intervention: Single Vs Multiple Inflations Of Drug-Eluting Balloons

Background: Drug-eluting balloons (DEBs) are increasingly used in percutaneous coronary intervention (PCI), particularly for patients with small vessel disease or those unsuitable for stent implantation. However, the optimal inflation strategy for DEBs remains unclear. The aim of this research was to compare one-year outcomes of single versus multiple inflations of the same DEB during elective PCI Methods: This prospective study was conducted at Ch Pervaiz Elahi Institute of Cardiology, Multan, from 4th April 2024 to 4th April 2025. A total of 86 patients aged 40-75 years of both genders with de novo coronary lesions received either single (Group A) or multiple (Group B) inflations of the same DEB. All patients underwent lesion preparation with pre-dilatation, followed by DEB-only angioplasty. The main outcome was late lumen loss (LLL) at one year. Secondary endpoints included target lesion revascularization, binary restenosis, and major adverse cardiovascular events. Results: Group B (multiple inflations) showed significantly lower LLL (0.21 ± 0.09 mm) as compared to Group A(0.35 ± 0.12 mm)(p=0.01). TLR and binary restenosis rates were numerically lower in Group B (4.7% vs. 13.9% and 2.3% vs. 11.6%, respectively), though not statistically significant. No differences in MACE were observed. Procedural success was 100% in both groups. Multiple inflations were associated with significantly lower late lumen loss at one year (0.21 mm) as compared to single inflations (0.35 mm) (p = 0.01). A trend toward lower TLR and binary restenosis was observed in the multiple-inflation group (p>0.05). Conclusion: Multiple inflations of the same DEB result in significantly lower late lumen loss and favourable trends in restenosis and revascularization compared to single inflation. This simple modification may enhance DEB efficacy and should be considered in routine PCI practice, especially in resource-limited settings.