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Drug-Coated Balloons for Coronary Artery Disease: Third Report of the International DCB Consensus Group

Raban V Jeger1, Simon Eccleshall2, Wan Azman Wan Ahmad3

  • 1University Hospital Basel, University of Basel, Basel, Switzerland.

JACC. Cardiovascular Interventions
|June 1, 2020
PubMed

Insights

Drug-coated balloons (DCBs) offer a novel alternative to stenting for coronary artery disease, particularly in specific situations like small vessels. DCBs provide drug delivery without permanent implants, showing promise in various patient groups.

Area of Science:

  • Interventional Cardiology
  • Vascular Medicine
  • Biomaterials Science

Background:

  • Drug-eluting stents are standard for coronary artery disease.
  • Drug-coated balloons (DCBs) offer an implant-free therapeutic option.
  • DCBs utilize antiproliferative drugs delivered via a lipophilic matrix.

Purpose of the Study:

  • To provide an updated consensus on drug-coated balloons (DCBs).
  • To summarize the historical background, technical aspects, and indications for DCBs.
  • To discuss future perspectives for DCB technology in interventional cardiology.

Main Methods:

  • Review of recent randomized clinical data.
  • Analysis of technical considerations for DCB device selection and implantation.
  • Consensus-based recommendations from the International DCB Consensus Group.

Main Results:

  • DCBs demonstrate efficacy and safety in de novo small-vessel disease and high bleeding risk patients.
  • Established use for in-stent restenosis of both bare-metal and drug-eluting stents.
  • Emerging indications include bifurcation lesions, large vessels, diabetes, and acute coronary syndromes.

Conclusions:

  • DCBs are a viable alternative to stenting in select coronary artery disease scenarios.
  • The efficacy of DCBs is device- and formulation-dependent, lacking a "class effect".
  • Ongoing research and evolving indications highlight the expanding role of DCBs.

Keywords:
consensus statementcoronary artery diseasedrug-coated balloon

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