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Drug-coated balloon treatment in coronary artery disease: Recommendations from an Asia-Pacific Consensus Group

Ae-Young Her1, Eun-Seok Shin2, Liew Houng Bang3

  • 1Division of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Republic of Korea.

Cardiology Journal
|October 1, 2019
PubMed

Insights

Drug-coated balloon (DCB) offers a promising alternative to stenting for coronary artery disease (CAD), avoiding complications like stent thrombosis and long-term dual antiplatelet therapy (DAPT). These guidelines aim to expand DCB use for various coronary lesions.

Area of Science:

  • Interventional Cardiology
  • Vascular Medicine
  • Biomaterials Science

Background:

  • Coronary artery disease (CAD) is a leading global cause of death, with rapid increases in the Asia-Pacific region.
  • Drug-eluting stents (DES) have limitations including stent thrombosis, restenosis, neoatherosclerosis, and the need for dual antiplatelet therapy (DAPT).
  • Drug-coated balloons (DCB) offer a 'leave-nothing-behind' approach, directly delivering anti-proliferative drugs without permanent implants.

Purpose of the Study:

  • To provide evidence-based guidelines for the use of DCB in treating coronary artery disease (CAD).
  • To extend the application of DCB to a wider range of coronary lesions, including de novo lesions.
  • To guide the effective and correct clinical application of DCB in interventional cardiology.

Main Methods:

  • Review of current scientific evidence and clinical reports on DCB technology.
  • Analysis of DCB performance in various lesion types, including restenosis and de novo lesions.
  • Consideration of fractional flow reserve (FFR) guided DCB application for larger coronary arteries.

Main Results:

  • DCB treatment is recommended as a first-line option for metal stent-related restenosis.
  • DCB application is expanding to de novo lesions such as small vessels, bifurcations, and chronic total occlusions.
  • FFR-guided DCB application shows safety and good long-term outcomes in larger coronary lesions.

Conclusions:

  • DCB technology presents a viable alternative to stenting, mitigating risks associated with implants.
  • Guidelines are established to promote wider and more effective utilization of DCB in clinical practice.
  • DCB offers a treatment strategy free from stent thrombosis and prolonged DAPT requirements.

Keywords:
Asia-Pacificcoronary artery diseasede novo lesiondrug-coated balloonin-stent restenosis

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