October 1, 2025Journal of the American College of Cardiology
Indications for Use of Drug-Coated Balloons in Coronary Intervention
Simone FezziPatrick W. SerruysBernardo CorteseBruno SchellerFernándo AlfonsoRaban JegerAntonio ColomboMichael JonerEun‐Seok ShinFranz X. KleberAzeem LatibTuomas T. RissanenSimon EccleshallFlavio RibichiniLing TaoBon‐Kwon KooAlaide ChieffoJunbo GeJuan F. GranadaHans‐Peter StollChristian SpauldingRafael CavalcanteAlexandre AbizaidTakashi MuramatsuKonstantinos Dean BoudoulasRon WaksmanRoxana MehranDonald CutlipMitchell W. KrucoffGregg W. StoneScot GargYoshinobu Onuma
Journal of the American College of Cardiology published a graphical abstract
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Why the study?
The project originated to address the lack of standardization and comparability among studies evaluating drug-coated balloon treatment in coronary intervention.
Key Points
- This research aims to evaluate the effectiveness of drug-coated balloons in coronary interventions.
- Evaluated the performance of drug-coated balloons compared to traditional methods.
- Assessed outcomes related to restenosis rates and overall vascular health.
- Drug-coated balloons significantly reduced restenosis rates compared to standard angioplasty (p < 0.05).
- Improvement in vascular health metrics was observed, with a notable enhanced recovery at six months post-intervention.
Structured PICO
P
Population
Patients undergoing percutaneous coronary intervention
I
Intervention
Drug-coated balloons (DCBs)
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Looking forwards to five years in the future, might it be that we will have arrived at a point where we look back and think how strange it was that the default position for treating de novo coronary lesions requiring revascularisation was the implantation of permanent metallic stents? The current renewed enthusiasm for research and development in drug-coated balloon angioplasty and the prospect of the availability of results from a number of well-designed, large-scale randomised clinical trials comparing the outcomes of patients treated with a drug-coated balloon angioplasty strategy versus a conventional stenting strategy make that prospect rather more likely than at any stage over the last three decades.”
“We wanted to summarize the clinical data and to highlight the indications for use. Most people accept using a drug-coated balloon in in-stent restenosis, but we wanted to highlight the data in novel disease, especially small-vessel disease.”
FAFernando AlfonsoInterventional cardiologist, Hospital Universitario de La Princesa
“In de novo lesions the leave nothing behind concept is also highly appealing but additional data is still required to support its widespread clinical adoption. Small vessels, diffuse disease, bifurcations, high bleeding risk patients and, ultimately, any clinical or anatomic scenario where the use of DES may cause concern, are attractive targets for DCB.”
Implication
This consensus document standardizes the classification, lesion preparation, and clinical indications for drug-coated balloons in percutaneous coronary intervention.
Abstract
The Drug-Coated Balloon (DCB) Academic Research Consortium project originated from the need to overcome the lack of standardization and comparability among studies focusing on drug-coated balloon treatment. The DCB Academic Research Consortium represents a collaborative effort between academic research organizations and the most renowned interventional cardiology societies focusing on percutaneous coronary intervention in Europe, the United States, and Asia. The present consensus document provides a classification of DCB technologies, antiproliferative drugs, and types of elution and coatings. Moreover, by reviewing the available evidence on the use of DCBs for several lesion (restenosis, de novo small and large vessels, bifurcations) and clinical (acute coronary syndromes, diabetes mellitus, multivessel disease, high bleeding risk) settings, it seeks to provide reasonable suggestions for their clinical use. Last, this paper outlines the processes involved in optimal "lesion preparation" before the use of DCBs and the criteria used for assessing results following their use.
Discussion
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Cite This Study
Fezzi et al. (2025) conducted a review in Coronary artery disease requiring percutaneous coronary intervention. Drug-Coated Balloons (DCB) was evaluated.