Key result
Physiology-guided provisional drug-coated balloon treatment using fractional flow reserve after optimal balloon angioplasty safely reduces unnecessary stent implantations in de novo coronary lesions.
Why the study?
While DCBs minimize long-term safety concerns of DES, evaluating whether angiography or physiology should guide successful DCB treatment of stenotic lesions remains needed.
This review evaluates the evidence for angiography- versus physiology-guided drug-coated balloon application to optimize treatment efficiency and safety in de novo coronary lesions.
Physiology-guided DCB may refine lesion treatment versus angiography; leaves open need for RCTs before practice change.
Although drug-eluting stents (DES) have become the mainstay of percutaneous coronary intervention, late and very late stent thrombosis remains a concern. Drug-coated balloons (DCB) have the advantage of preserving the anti-restenotic benefits of DES while minimizing potential long-term safety concerns. Currently the two methods to ensure successful DCB treatment of a stenotic lesion are angiography or physiology-guided DCB application. This review will evaluate these two methods based on previous evidence and make suggestions on how to perform DCB treatment more efficiently and safely.
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Shin et al. (2020) conducted a review in Coronary artery disease (de novo lesions). Physiology-guided drug-coated balloon treatment vs. Angiography-guided treatment or drug-eluting stents was evaluated. Physiology-guided provisional drug-coated balloon treatment using fractional flow reserve after optimal balloon angioplasty safely reduces unnecessary stent implantations in de novo coronary lesions.
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