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ST-Segment Elevation Myocardial Infarction Patients in the Coronary Care Unit Is it Time to Break Old Habits? Effects of Aspirin for Primary Prevention in Persons with Diabetes Mellitus Complete Revascularization with Multivessel PCI for Myocardial Infarction The optimal duration of dual antiplatelet therapy after coronary stent implantation: to go too far is as bad as to fall short Hs-cTroponins for the prediction of recurrent cardiovascular events in patients with established CHD - A comparative analysis from the KAROLA study Long-term outcomes of rotational atherectomy of underexpanded stents. A single center experience Randomized Comparison of Ridaforolimus-Eluting and Zotarolimus-Eluting Coronary Stents 2-Year Clinical Outcomes: From the BIONICS and NIREUS Trials Outcome of Applying the ESC 0/1-hour Algorithm in Patients With Suspected Myocardial Infarction Single-Molecule hsTnI and Short-Term Risk in Stable Patients With Chest Pain Validation of High-Risk Features for Stent-Related Ischemic Events as Endorsed by the 2017 DAPT Guidelines

Review Article2017 Jul;14(7):841-850

JOURNAL:Expert Opin Drug Deliv. Article Link

Drug-eluting balloons in coronary interventions: the quiet revolution?

Alfonso F, García-Guimaraes M, Navarrete G et al. Keywords: drug-eluting balloon; extended release; in-stent restenosis; porous angioplasty balloon; sirolimus nanoparticle

ABSTRACT

INTRODUCTION - Drug-eluting balloons (DEB) may be considered as a 'quiet revolution' in percutaneous coronary interventions. Early-generation DEB eluting paclitaxel proved to be very effective in animal models to reduce neointimal hyperplasia. Areas covered: Review of DEB efficacy in patients with coronary de novo lesions and in-stent restenosis (ISR). Expert opinion: Many randomized clinical trials and meta-analyses have demonstrated the value of DEB in patients with ISR. In this setting, DEB are safe and effective with clinical and angiographic results superior to plain balloon angioplasty and at least equivalent to first generation drug-eluting stents (DES). In selected 'de novo' lesions (bifurcation lesions, small vessels, diffuse disease, myocardial infarction) DEB represent an attractive alternative although additional evidence in these 'niche' indications is still required before a widespread clinical utilization can be recommended. Recently, new generation DEB have become available, offering interesting new possibilities (paclitaxel and also sirolimus) for coronary interventions. Further studies are required to compare the results of novel generation DEB with those of second-generation DES.