Key result
Drug-coated balloons are a promising technique for selected de novo coronary lesions in small vessel disease, demonstrating similar efficacy to drug-eluting stents, though further studies are required to ascertain long-term benefits.
Why the study?
Newer-generation DES show a lack of efficacy in small coronary arteries due to higher rates of restenosis, thrombosis, and MI, making DCBs a promising alternative.
Systematic Review
This review highlights drug-coated balloons as a promising alternative to drug-eluting stents for treating small coronary vessel disease and in-stent restenosis.
May warrant consideration for selected small vessel lesions; leaves open long-term outcomes versus stents.
Newer-generation drug-eluting stents (DES) are the standard of care for the treatment of symptomatic coronary artery disease. However, some lack of efficacy has been reported in small coronary arteries based on higher rates of target lesion restenosis, thrombosis and MI resulting in repeated interventions. Drug-coated balloons (DCBs) are an established treatment option for in-stent restenosis in both bare metal stents and DES and they can deliver an anti-proliferative drug into the vessel wall without implanting a stent. DCBs are a promising technique for selected de novo coronary lesions, especially in small vessel disease. In this article, the current evidence for the treatment of small vessel disease with DCBs will be reviewed.
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Nestelberger et al. (2019) conducted a systematic review in Small vessel coronary artery disease. Drug-coated balloons vs. Drug-eluting stents was evaluated. Drug-coated balloons are a promising technique for selected de novo coronary lesions in small vessel disease, demonstrating similar efficacy to drug-eluting stents, though further studies are required to ascertain long-term benefits.
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