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Diagnosis and management of acute deep vein thrombosis: a joint consensus document from the European Society of Cardiology working groups of aorta and peripheral vascular diseases and pulmonary circulation and right ventricular function A Case of Pulmonary Hypertension Associated with Idiopathic Hypereosinophilic Syndrome Lysed Erythrocyte Membranes Promote Vascular Calcification: Possible Role of Erythrocyte-Derived Nitric Oxide Increased pulmonary serotonin transporter in patients with chronic obstructive pulmonary disease who developed pulmonary hypertension The Relation Between Optical Coherence Tomography-Detected Layered Pattern and Acute Side Branch Occlusion After Provisional Stenting of Coronary Bifurcation Lesions Influence of Heart Rate on FFR Measurements: An Experimental and Clinical Validation Study Diagnosis of ischemia-causing coronary stenoses by noninvasive fractional flow reserve computed from coronary computed tomographic angiograms. Results from the prospective multicenter DISCOVER-FLOW Nicotine promotes vascular calcification via intracellular Ca21-mediated, Nox5-induced oxidative stress, and extracellular vesicle release in vascular smooth muscle cells Evolving understanding of the heterogeneous natural history of individual coronary artery plaques and the role of local endothelial shear stress Real-world clinical utility and impact on clinical decision-making of coronary computed tomography angiography-derived fractional flow reserve: lessons from the ADVANCE Registry

Review ArticleVolume 75, Issue 9, March 2020

JOURNAL:J Am Coll Cardiol. Article Link

Drug-Coated Balloon for De Novo Coronary Artery Disease: JACC State-of-the-Art Review

C Yerasi, BC Case, BJ Forrestal et al. Keywords: CAD; DCB; drug-eluting balloon; paclitaxel-coated balloon; paclitaxel-eluting balloon; small-vessel disease

ABSTRACT


Percutaneous coronary intervention with a drug-eluting stent is the most common mode of revascularization for coronary artery disease. However, restenosis rates remain high. Non-stent-based local drug delivery by a drug-coated balloon (DCB) has been investigated, as it leaves no metallic mesh. A DCB consists of a semicompliant balloon coated with antiproliferative agents encapsulated in a polymer matrix, which is released into the wall after inflation and contact with the intima. DCB have demonstrated effectiveness in treating in-stent restenosis. Clinical studies using DCB in de novo coronary artery disease have shown mixed results, with a major benefit in small-vessel disease. Differences in study results are not only due to variations in DCB technology but also to disparity in procedural approach, “leave nothing behind” or “combination therapy,” and vessel size. This review focuses on the available evidence from randomized trials and proposes a design for future clinical trials.