Key result
DCBs provide a safe, effective alternative to DES in de novo coronary lesions.
Why the study?
While drug coated balloons are a guideline-indicated first choice for in-stent restenosis, their role and indications in de novo coronary artery disease have remained debated.
Do drug coated balloons improve clinical and angiographic outcomes compared to stents or plain balloon angioplasty in patients with de novo coronary artery disease?
Do drug coated balloons improve clinical and angiographic outcomes compared to stents or plain balloon angioplasty in patients with de novo coronary artery disease?
Drug-coated balloons represent a viable 'leave nothing behind' strategy for de novo coronary lesions, particularly in small vessels, bifurcations, and diabetic patients, showing comparable efficacy to drug-eluting stents.
May warrant DCB consideration in small-vessel or high-bleeding-risk de novo lesions; leaves open superiority over DES pending randomized data.
Drug coated balloons (DCBs) are currently indicated in guidelines as a first choice option in the management of instant restenosis, whereas their use in de novo lesions is still debated. The concerns raised after the contrasting results of the initial trials with DCBs in de novo lesions have been more recently overcome by a larger amount of data confirming their safety and effectiveness as compared to drug-eluting stents (DES), with potentially greater benefits being achieved, especially in particular anatomical settings, as in very small or large vessels and bifurcations, but also in selected subsets of higher-risk patients, where a 'leave nothing behind' strategy could offer a reduction of the inflammatory stimulus and thrombotic risk. The present review aims at providing an overview of current available DCB devices and their indications of use based on the results of data achieved so far.
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Zilio et al. (2023) conducted a review in De novo coronary artery disease. Drug coated balloons (DCBs) vs. Drug-eluting stents (DES) or plain old balloon angioplasty (POBA) was evaluated. Drug-coated balloons offer a safe and effective alternative to drug-eluting stents in de novo coronary lesions, particularly in small vessels, bifurcations, and high bleeding risk patients.
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