Drug-Coated Balloons: Technologies and Clinical Applications

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Biomaterials Science

Background:

• Drug-coated balloons (DCBs) are emerging as a key alternative to stenting for treating peripheral artery disease (PAD) and coronary artery disease (CAD).
• Existing studies and meta-analyses provide a foundation for evaluating DCB efficacy across various lesion types.
• A comprehensive review is needed to consolidate current clinical data and guide future research and application.

Purpose of the Study:

• To compile and review the latest clinical data on drug-coated balloon (DCB) strategies in peripheral and coronary artery diseases.
• To assess the efficacy and safety of DCBs in specific applications, including in-stent restenosis and bifurcation lesions.
• To discuss the limitations of current DCB technology and the advancements in newer generation devices.

Main Methods:

• Systematic review of published studies and meta-analyses on drug-coated balloon interventions.
• Analysis of clinical outcomes, including angiographic and patient-reported data.
• Evaluation of safety profiles and feasibility across different vascular beds and lesion types.

Main Results:

• Clinical evidence supports the use of DCBs in peripheral artery disease (PAD) and coronary in-stent restenosis (ISR).
• DCB application in side branch treatment of bifurcation lesions demonstrates feasibility, safety, and favorable outcomes.
• DCB use for arteriovenous fistula and graft stenoses shows promise but requires further clinical validation.

Conclusions:

• Drug-coated balloons are a viable non-stent option for PAD and CAD, particularly for ISR and specific bifurcation lesions.
• Further clinical investigation is warranted for DCB application in arteriovenous access lesions.
• Ongoing development of next-generation DCBs aims to overcome current limitations and expand therapeutic potential.