Will the TRANSFORM II trial transform our management of small vessel coronary disease?

Percutaneous coronary interventions (PCI) in small vessels and long lesions are associated with poor outcomes. Drug eluting balloons (DEB) are an acceptable alternative to drug eluting stents (DES) in countries where DEB are commercially available, however there are limited data on sirolimus eluting balloons (SES) for small vessel coronary lesions and no randomized trials. The TRANSFORM II trial will randomize 1325 patients with small vessels (2-3 mm diameter) to receive SEB versus everolimus eluting stents to determine 1 year outcomes.