Drug-Coated Balloons for Coronary Interventions: A Focused Review

Area of Science:

• Cardiology
• Interventional Cardiology
• Biomaterials Science

Background:

• Catheter-based interventions have transformed coronary artery disease (CAD) treatment.
• Drug-coated balloons (DCBs) represent an advancement, delivering antiproliferative drugs to the vessel wall.
• DCBs offer an alternative to permanent metallic implants, potentially reducing thrombotic risks.

Purpose of the Study:

• To review the evolution and clinical applications of DCBs in CAD management.
• To focus on DCBs' role in treating in-stent restenosis (ISR), de novo lesions, and complex coronary anatomies.
• To evaluate DCBs as an alternative to traditional stent-based therapies.

Main Methods:

• Literature review of studies on DCB technology and clinical outcomes in CAD.
• Analysis of DCB efficacy in various lesion subsets, including ISR, small vessels, bifurcations, and long diffuse lesions.
• Comparison of DCB performance against drug-eluting stents in relevant patient populations.

Main Results:

• DCBs have demonstrated effectiveness in treating ISR.
• Recent studies show expanded applications for DCBs in complex lesions and small vessels.
• DCBs have shown non-inferiority to drug-eluting stents in specific patient groups and lesion types.
• Challenges include potential for coronary dissection and need for optimal lesion preparation.

Conclusions:

• DCBs show strong potential for reducing restenosis and improving long-term outcomes in CAD.
• They offer a versatile, effective, and potentially safer approach compared to traditional stenting.
• Further research is needed to optimize DCB use in off-label indications.