Drug-Eluting Balloon for Coronary In-Stent Restenosis: Could it be an Emerging Strategy?

Despite significant improvement in PCI, including drug-eluting stent (DES) applications, in-stent restenosis (ISR) remains a problem. ISR is challenging to manage. Repeat stenting with bare metal stent (BMS), repeat stenting with DES and bioresorbable vascular scaffolds is primarily used to prevent and treat ISR. Current European guidelines recommend DES or a drug-eluting balloon (DEB) to treat ISR with a Class I indication. However, its use in coronary artery interventions has not yet been approved in the United States. DEB allows the application of the antiproliferative drug to the ISR site without leaving an additional layer of stent strut. Studies show that DEB is superior to plain balloon alone and comparable to DES in ISR treatment. They are increasingly preferred due to their good therapeutic effect in preventing intimal proliferation and restenosis. This review aims to provide an overview on the feasibility of using DEB in ISR management based on current knowledge