Paclitaxel-coated drug-coated balloon reduced target lesion failure to 17.9% compared to 28.6% with uncoated balloon at 12 months in patients with coronary in-stent restenosis.
Do drug-coated balloons provide a safe and effective alternative to conventional strategies in coronary lesions beyond in-stent restenosis?
Drug-coated balloons offer a promising stent-free alternative to drug-eluting stents across a broad spectrum of coronary lesions beyond in-stent restenosis, potentially reducing stent-related complications and allowing for shorter dual antiplatelet therapy.
Effect estimate: p=0.003
Absolute Event Rate: 17.9% vs 28.6%
p-value: p=0.003
Drug-coated balloons (DCBs) are rapidly gaining prominence, owing to the associated expanding clinical applications and therapeutic potential in interventional cardiology. Moreover, a growing body of evidence from randomized trials, observational studies, and meta-analyses supports the efficacy of DCBs across a broad spectrum of coronary lesions, positioning these devices as a viable, stent-free alternative to conventional strategies. DCBs aim to lower the risks inherent to stent implantation, such as stent thrombosis and in-stent restenosis (ISR), and to enable abbreviated dual antiplatelet therapy in high-bleeding-risk (HBR) patients. Although drug-eluting stents (DESs) remain the current standard in percutaneous coronary intervention, DCBs are emerging as a novel and promising option in diverse clinical settings beyond ISR, including de novo lesions in both small and large vessels, bifurcation disease, patients with a high risk of bleeding, and even acute coronary syndromes. This article aims to provide a comprehensive review of the evolving role, evidence base, and expanding indications of DCB-related therapy beyond ISR.
Gupta et al. (Wed,) conducted a review in Patients with coronary in-stent restenosis treated with drug-coated balloon versus uncoated balloon (n=600). Paclitaxel-coated drug-coated balloon (DCB) vs. Uncoated balloon angioplasty was evaluated on Target lesion failure (TLF) at 12 months (p=0.003, p=0.003). Paclitaxel-coated drug-coated balloon reduced target lesion failure to 17.9% compared to 28.6% with uncoated balloon at 12 months in patients with coronary in-stent restenosis.