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Percutaneous Left Atrial Appendage Transcatheter Occlusion (PLAATO System) to Prevent Stroke in High-Risk Patients With Non-Rheumatic Atrial Fibrillation: Results From the International Multi-Center Feasibility Trials 5-Year Outcomes of PCI Guided by Measurement of Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve Thrombotic Risk and Antithrombotic Strategies After Transcatheter Mitral Valve Replacement Transcatheter Interventions for Mitral Regurgitation: Multimodality Imaging for Patient Selection and Procedural Guidance Initial Worldwide Experience With the WATCHMAN Left Atrial Appendage System for Stroke Prevention in Atrial Fibrillation Italian Society of Interventional Cardiology (GIse) Registry Of Transcatheter Treatment of Mitral Valve RegurgitaTiOn (GIOTTO): Impact of Valve Disease Etiology and Residual Mitral Regurgitation after MitraClip Implantation Association Between Malignant Mitral Valve Prolapse and Sudden Cardiac Death: A Review 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension Initial experience with percutaneous mitral valve repair in patients with cardiac amyloidosis Transcatheter Interventions for Tricuspid Valve Disease: What to Do and Who to Do it On

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.