DRUG-COATED BALLOON ANGIOPLASTY IN REAL-WORLD CLINICAL PRACTICE: SINGLE-CENTRE EXPERIENCE FROM KAZAKHSTAN

Introduction. Drug-coated balloons (DCB) deliver an antiproliferative agent to the vessel wall during a single balloon inflation without leaving a permanent implant. Real-world data from Kazakhstan and Central Asia remain limited. Aim. To assess the procedural safety and mid-term clinical outcomes of DCB angioplasty in a consecutive real-world cohort with de novo coronary lesions and in-stent restenosis treated at a single interventional cardiology centre in Kazakhstan. Materials and methods. This retrospective, single-centre observational study included 102 consecutive patients treated with the MagicTouch™ sirolimus-coated balloon (Concept Medical) between August 2024 and May 2025 (data cut-off 31 May 2026). The cohort comprised de novo lesions, in-stent restenosis, small-vessel disease (<2.5 mm), distal and bifurcation lesions, and hybrid procedures. Clinical outcomes were assessed at 3, 6 and 12 months. The primary endpoint was major adverse cardiovascular events (MACE): cardiac death, non-fatal myocardial infarction and clinically driven target lesion revascularization. Results. Mean age was 63.2 ± 9.4 years; 66.7% were male; 37.3% had diabetes and 21.6% chronic kidney disease. A bail-out stent was required in 17.6%. Procedural success was achieved in 97.1%. At 12 months, MACE occurred in 5 of the 92 patients with complete follow- up (5.4%); all events were clinically driven target lesion revascularization (5/92; 5.4%), with no non-fatal myocardial infarction (0/92) and no cardiac death (0/92). Freedom from angina (CCS class 0) was documented in 66/92 (71.7%) and CCS class 0–II in 85/92 (92.4%). No vessel thrombosis was recorded. Conclusion. In this observational cohort, DCB angioplasty was associated with high procedural success, progressive symptomatic improvement and no observed vessel thrombosis across small-vessel disease, in-stent restenosis, and distal and bifurcation lesions. As a single- arm study, it cannot establish comparative safety or efficacy versus drug-eluting stents; prospective multicentre studies with angiographic endpoints are warranted.