Research status and trends of drug-coated balloons in coronary artery disease: a bibliometric analysis

Objective Drug-coated balloons have emerged as a pivotal alternative to drug-eluting stents in the interventional management of coronary artery disease, particularly showing clinical advantages in the treatment of in-stent restenosis and small-vessel disease. This study provides a systematic bibliometric analysis of publication trends, research hotspots, and future directions in DCB-related CAD research from 2004 to June 2025. Methods A total of 1,092 publications indexed in the Web of Science, Scopus, and PubMed databases were analyzed using CiteSpace, VOSviewer, and bibliometrix. Inclusion criteria were English-language papers, while case reports, conference proceedings, news articles, and duplicate publications were excluded. The analysis focused on publication trends, country/institutional contributions, author collaboration networks, journal analysis, co-citation literature, and keyword evolution. Results Three distinct developmental phases of DCB research were identified: (1) device optimization (2004–2010), (2) clinical validation (2010–2017), and (3) application to complex lesions (2018–present). China led in publication volume ( n = 180), while Germany and Italy demonstrated the highest research impact. Leading research institutions included Capital Medical University and Friedrich Schiller University of Jena. High-impact journals such as JACC: Cardiovascular Interventions and EuroIntervention served as key publication venues, with a focus on clinical outcomes and intravascular imaging. Keyword analysis revealed a growing emphasis on intravascular imaging modalities and emerging drug-coating technologies in recent research. Conclusion DCB are now established as a standard of care for ISR (Class IA recommendation), with accumulating evidence supporting their efficacy and safety in small-vessel coronary disease. However, their application in complex lesions requires further validation through multicenter randomized controlled trials. Future research should focus on optimizing drug coating technologies, refining imaging-guided strategies, exploring new anti-proliferative drugs, and establishing more precise eligibility criteria for treatment.