Coronary Drug-Coated Balloons: Should We Choose a Stentless Approach?
DCB: Stentless Approach?
DOI:
https://doi.org/10.5281/zenodo.8031627Keywords:
Coronary artery disease, DCBs, drug-coated balloons, indication, perspectiveAbstract
Although drug-eluting stents are still the standard interventional treatment for coronary artery disease, drug-coated balloons (DCBs) represent a novel alternative therapeutic approach in specific anatomic situations. DCBs work by rapidly and uniformly transferring antiproliferative medications into the vessel wall during single balloon inflation using a lipophilic matrix, all without the need for long-term implants. Despite the fact that their usage is well-established for in-stent restenosis of both bare-metal and drug-eluting stents, current randomized trial data show a strong effectiveness and safety profile in de novo small-vessel disease and high bleeding risk. There are also newer signs that are emerging, such as bifurcation lesions, large-vessel disease, diabetes mellitus, and acute coronary syndromes. These expanding indications for DCBs may potentially reduce the reliance on coronary stents or shift towards a stentless perspective.
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