***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES This observational study assessed the 9-month clinical outcomes in patients with coronary bifurcation lesions suitable for drug-coated balloon ( DCB ) angioplasty .  It was the intention to use DCB 's without additional stenting ( DCB-only strategy ) in selected patients for this chosen strategy . Bail-out main branch ( MB ) and /or side branch ( SB ) stenting , however , were permissible when flow limiting dissections or excessive recoil occurred . BACKGROUND A multitude of interventional strategies have been studied to treat bifurcation lesions . With the availability of DCB angioplasty , investigators have been using this interventional tool with the optional implantation of bare metal stents ( BMS ) . METHODS This study is an international , prospect i ve , multicenter registry enrolling patients with coronary bifurcation lesions including a side branch ≥2 mm in diameter . Patients with stable angina and documented ischemia or selected forms of unstable angina due to a culprit bifurcation lesion of any Medina classification type were recruited . The primary endpoint was clinical ly driven target-lesion revascularization ( TLR ) at 9 months . Secondary endpoints included 9-month major adverse cardiac events ( death , myocardial infa rct ion , or TLR ) , technical success , in-hospital outcomes and vessel thrombosis rates . RESULTS A total 127 patients 66.1 ± 10.1 years of age were enrolled . Demographic characteristics were 80.3 % ( 102/127 ) male gender , 31.5 % ( 40/127 ) diabetes , 91.3 % ( 116/127 ) hypertension , 7.1 % ( 9/127 ) ST-elevation myocardial infa rct ion ( STEMI ) , and 9.4 % ( 12/127 ) non ST-elevation myocardial infa rct ion ( NSTEMI ) . The 130 lesions were treated with 184 DCB 's and 64 BMS . In 53.8 % ( 70/130 ) of all lesions the DCB-only strategy could be used while 34.6 % ( 45/130 ) of lesions had at least 1 stent ( BMS ) in the main branch , 8.5 % ( 11/130 ) had at least 1 stent in the side branch and 3.1 % ( 4/130 ) needed at least 1 stent in the main and side branch . 94.5 % patients ( 121/127 ) were available for follow-up after 9.8 ± 2.0 months . The TLR rate was 4.6 % in the absence of any thrombotic events in the treated vessels whereas the 9-month MACE rate was 6.2 % . CONCLUSION This observational study suggests that the DCB-only strategy is safe and effective to treat selected bifurcations while benefiting from a shortened dual antiplatelet therapy ( DAPT ) Background : Coronary angioplasty in advanced age is associated with higher rate of comorbidities and complications . Drug coated balloon only angioplasty ( DCBA ) has emerged as an alternative to treat small vessel coronary disease ( SVCD ) , of reference vessel diameters < 2.8 mm , with shorter duration of dual antiplatelet ( DAPT ) . This is the first study to assess the DCBA efficacy in an elderly population with SVCD . Methods and results : We performed a prospect i ve study of 447 patients ( 334 patients aged < 75 and 113 patients aged ⩾75 years old ) acquired from the SeQuent Please Small Vessel ‘ Paclitaxel-Coated Balloon Only ’ registry . In the older age group , more patients have hypertension ( 89 % versus 77 % ; p = 0.006 ) , renal insufficiency ( 21 % versus 6 % ; p < 0.001 ) , atrial fibrillation ( 17 % versus 7 % ; p = 0.001 ) , and calcified lesions ( 33 % versus 20 % ; p = 0.006 ) . At 30 days , there was one myocardial infa rct ion requiring target lesion revascularization ( TLR ) in the younger group . No major adverse cardiac event ( MACE ) was observed in the older group . At 9 months , the MACE rate in the younger group was 4.2 % and 6.1 % in the older group ( p = 0.453 ) , with TLR rates at 3.9 % and 3.0 % ( p = 0.704 ) respectively . There was no cardiac death observed . Conclusion : DBCA in the elderly with SVCD is as safe and effective compared with younger patients despite more complex anatomy and comorbidities Background : Drug‐eluting stents ( DES ) represent a significant evolution in the treatment of patients with acute myocardial infa rct ion with ST elevation . However , stent‐related adverse events have led to an introduction of drug‐coated balloons ( DCB ) applied particularly to bifurcation lesions , in‐stent restenosis and small vessel disease . The aim of this study was to determine whether a DCB‐only strategy has a similar safety profile and equal angiographic and clinical outcomes to DES implantation in primary percutaneous coronary intervention ( pPCI ) . Material s and Methods : Seventy‐five patients with acute myocardial infa rct ion with ST elevation were r and omized into DES and DCB groups of 37 and 38 patients , respectively . The study end‐points were major adverse cardiac events and late lumen loss during the 6 months following the pPCI . Results : Reinfa rct ion occurred in 5.4 % of patients in the DES and 5.3 % of patients in the DCB group after 1 month ( risk ratio = 1.03 , 95 % CI [ 0.15‐6.91 ] , P = 0.98 ) . After 6 months , major adverse cardiac events were reported in 5.4 % of patients in the DES group and none in the DCB group ( risk ratio = 5.13 , 95 % CI [ 0.25‐103.42 ] , P = 0.29 ) . Late lumen loss in the DES group was 0.10 ± 0.19 mm and −0.09 ± 0.09 mm in the DCB group ( P < 0.05 ) . Conclusions : A DCB‐only strategy is safe and feasible in the pPCI setting and showed good clinical and angiographic outcomes in a 6‐month follow‐up period BACKGROUND Drug-eluting balloons ( DEB ) are an alternative treatment of in-stent restenosis ( ISR ) , but data regarding outcomes of DEB in de novo lesions are lacking . METHODS AND RESULTS We investigated the effect of DEB on target lesion revascularization ( TLR ) , procedural complications ( coronary dissection/rupture , pericardial effusion , stent thrombosis , peri-interventional NSTEMI , stroke ) , major adverse cardiac and cerebrovascular events ( all-cause mortality , myocardial infa rct ion , TLR , stroke ) in patients with ISR and de novo lesions in an all-comers setting . Between April 2009 and October 2013 , 484 consecutive patients ( mean age 68.4 years ; 77.9 % male ) were enrolled in a prospect i ve registry .  TLR rate was 4.9 % at 12 months and 8.7 % at long-term follow-up of 2.3 years . Subgroup analysis confirmed a TLR rate of 8.9 % after DEB treatment of ISR in bare-metal stents ( 21/235 lesions ) , 13.0 % in drug-eluting stents ( 21/161 lesions ) and 0 % for de novo lesions ( 0/76 lesions ) . At long-term follow-up , all-cause mortality/cardiac mortality was 8.7 % (42/484)/3.3 % ( 16/484 ) and MACCE rate was 18.4 % ( 89/484 patients ) , with no differences between DEB for ISR compared with de novo lesions . CONCLUSIONS DEB for ISR result ed in a low rate of TLR . Our data support DEB in ISR as an effective treatment option . DEB in small coronary vessels in our limited cohort appeared to be safe . Larger , r and omized trials in small coronary vessels should be undertaken to verify the long-term results of the current trial OBJECTIVES To evaluate the impact of diabetes on the efficacy of drug-eluting balloon ( DEB ) as compared to paclitaxel-eluting stent ( PES ) for the reduction of restenosis in small vessels according to the presence of diabetes in patients enrolled in the BELLO ( Balloon Elution and Late Loss Optimization ) trial . BACKGROUND Small vessel disease is common in diabetic patients but currently there are no available data regarding DEB in these patients . METHODS In the BELLO trial , 182 patients with lesions in small vessels were r and omized 1:1 to receive DEB or PES . In the current sub analysis , patients were stratified according to the presence of diabetes . The diabetic group consisted of 74 patients ( DEB=39 , PES=35 ) and the nondiabetic group of 108 patients ( DEB=51 , PES=57 ) . Angiographic endpoints examined were in-stent/in-balloon and in-segment late loss and binary restenosis at 6 months . Clinical endpoints were major adverse cardiac events ( MACE ; death , myocardial infa rct ion , target vessel revascularization ) at 1 year . RESULTS In-stent/in-balloon late loss was significantly less with DEB as compared to PES in both diabetic ( 0.05±0.41 vs. 0.30±0.51 mm , p=0.033 ) and nondiabetic patients ( 0.10±0.36 vs. 0.29±0.40 mm , p=0.015 ) . In patients with diabetes , angiographic restenosis and in-segment late loss were significantly lower with DEB as compared to PES ( respectively , 6.3 % vs. 25.0 % ; p=0.039 and -0.013±0.39 vs. 0.25±0.53 ; p=0.023 ) , with no differences noted in nondiabetic patients . The cumulative MACE rate at 1 year was similar between DEB and PES in both the diabetic ( 13.2 % vs. 25 % , p=0.194 ) and nondiabetic groups ( 11.8 % vs. 14.3 % , p=0.699 ) . CONCLUSIONS Diabetes does not appear to have a negative impact on the efficacy of DEB in small vessels , which were associated with better angiographic outcomes at 6 months in this complex subgroup . Larger studies are needed to confirm these findings Background Treatment of lesions in small coronary arteries by percutaneous transluminal coronary intervention is limited by a high recurrence rate . We assessed the use of a paclitaxel-coated balloon in this indication . Methods One-hundred eighteen patients with stenoses in small coronary vessels were treated by a paclitaxel-coated balloon ( 3 μg/mm2 ) . The main inclusion criteria encompassed diameter stenosis of ≥70 % and ≤22 mm in length with a vessel diameter of 2.25–2.8 mm .  Follow-up angiography was performed at scheduled 6-month post-intervention or whenever driven by clinical or electrocardiographic signs of ischemia . The primary endpoint was angiographic in-segment late lumen loss . Results Eighty-two of 118 patients ( 70 % ) with a vessel diameter of 2.35 ± 0.19 mm were treated with the drug-coated balloon only , while 32 patients required additional stent deployment . The mean in-segment late lumen loss was 0.28 ± 0.53 mm . In patients treated with the drug-coated balloon only , the in-segment late lumen loss was 0.16 ± 0.38 mm . At 12 months , the rate of major adverse cardiac events was 15 % which was primarily due to the need for target lesion revascularization in 14 patients ( 12 % ) . In those with additional bare metal stent implantation geographical mismatch between coated-balloon dilatation and stent implantation was significantly associated with the occurrence of restenosis . Conclusion Treatment of coronary stenosis in small coronary vessels with the paclitaxel-coated balloon was well tolerated . It may offer an alternative to the implantation of a drug-eluting stent ( Clinical Trials.gov Identifier : NCT00404144 ) Purpose The effects on the side-branch ( SB ) ostium , following paclitaxel-coated balloon ( PCB ) treatment of de novo coronary lesions of main vessels have not been previously investigated . This study was aim ed at evaluating the serial morphological changes of the SB ostium after PCB treatment of de novo coronary lesions of main vessels using optical coherence tomography ( OCT ) . Material s and Methods This prospect i ve , single-center observational study enrolled patients with de novo lesions , which were traversed by at least one SB ( ≥1.5 mm ) and were treated with PCB .  The SB ostium was evaluated with serial angiographic and OCT assessment s pre- and post-procedure , and at 9-months follow-up . Results Sixteen main vessel lesions were successfully treated with PCB , and 26 SBs were 
    Output:
    
DCB-only PCI appears to be associated with comparable clinical outcomes to DESs and superior angiographic outcomes to plain-old balloon angioplasty .
A 4-week period of dual antiplatelet therapy provides a real advantage for the DCB-only PCI approach , which is not possible with most DESs .