Drug-Coated Balloons for Coronary Artery Disease: From Theory to Practice

The purpose of this work is to review the role of drug-coated balloons (DCBs) in contemporary coronary artery disease (CAD) management by focusing on its clinical indications and technical considerations, supported by updated insights from the International DCB Consensus Group.

While percutaneous coronary intervention (PCI) and drug-eluting stents were initially the standard treatment for CAD, limitations such in-stent stenosis, neoatherosclerosis, and increased bleeding led to the development of the novel DCBs. These DCBs have become well established in treating various clinical cases such as in-stent restenosis, de-novo small-vessel disease, bifurcation lesions, large-vessel disease, high bleeding risk, acute coronary syndromes, and diabetes mellitus.

For optimal DCB outcomes, functional assessments, careful lesion preparation, and patient selection are crucial for effective drug delivery and reduced complications. Ongoing innovations in drug formulations, balloon design, and delivery mechanisms, along with further trials, will expand DCBs' impact in CAD treatment.