Use of Drug-coated Balloons in Left Main In-stent Restenosis

Drug-coated balloons (DCBs) are an emerging technology in percutaneous coronary interventions (PCI). They have been used classically in in-stent restenosis (ISR). Their use in bifurcations is usually for PCI of the side branch as a hybrid approach. There are not many studies of the use of DCB in left main-ISR (LM-ISR) lesions, which is a rare and complex long-term complication of LM-PCI. We describe a case of LM-ISR lesion presenting with left circumflex chronic total occlusion in which DCB alone was used for the LM bifurcation to prevent complications related to excess metal layers.