Drug-coated balloons in cardiovascular disease: benefits, challenges, and clinical applications

Introduction: Newer-generation drug-eluting stents (DES) are the standard of care for the treatment of symptomatic coronary artery disease. However, their efficacy is limited by in-stent restenosis and stent thrombosis. Drug-coated balloons (DCB) are a treatment option for in-stent-restenosis and for certain clinical and anatomical situations in de novo diseases such as small coronary arteries, bifurcation lesions, and high bleeding risk situations.Areas covered: This review summarizes the current clinical status of DCB angioplasty in coronary artery disease.Expert opinion: DCB deliver an anti-proliferative drug into the vessel wall without implanting a stent and are a promising and technique in the treatment of coronary artery disease. Several studies and meta-analysis have demonstrated the safety and efficacy of DCB angioplasty for several indications such as in-stent restenosis, small-vessel disease, and high bleeding risk. Due to absent short- and long-term complications of stent implantation and a short dual antiplatelet therapy duration, DCB angioplasty has the potential to achieve a clear role in the interventional field in clinical settings with a comparable or even a superior efficacy in comparison with DES use.