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Long-Term Outcomes of Patients With Mediastinal Radiation–Associated Coronary Artery Disease Undergoing Coronary Revascularization With Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting Systematic Review and Network Meta‐Analysis Comparing Bifurcation Techniques for Percutaneous Coronary Intervention Current Status and Future Prospects of Transcatheter Mitral Valve Replacement: JACC State-of-the-Art Review Does pulsed field ablation regress over time? A quantitative temporal analysis of pulmonary vein isolation Implications of the local hemodynamic forces on the formation and destabilization of neoatherosclerotic lesions Transseptal puncture versus patent foramen ovale or atrial septal defect access for left atrial appendage closure 2015 ACC/HRS/SCAI Left Atrial Appendage Occlusion Device Societal Overview Evolving insights into the role of local shear stress in late stent failure from neoatherosclerosis formation and plaque destabilization Management and outcomes of patients with left atrial appendage thrombus prior to percutaneous closure Alcohol consumption, cardiac biomarkers, and risk of atrial fibrillation and adverse outcomes

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.