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Advances in Clinical Cardiology 2020: A Summary of Key Clinical Trials Incidence and Outcomes of Acute Coronary Syndrome After Transcatheter Aortic Valve Replacement Revascularization Strategies in STEMI with Multivessel Disease: Deciding on Culprit Versus Complete-Ad Hoc or Staged Classic crush and DK crush stenting techniques Subcutaneous Selatogrel Inhibits Platelet Aggregation in Patients With Acute Myocardial Infarction Prevalence of anginal symptoms and myocardial ischemia and their effect on clinical outcomes in outpatients with stable coronary artery disease: data from the International Observational CLARIFY Registry Short Sleep Duration, Obstructive Sleep Apnea, Shiftwork, and the Risk of Adverse Cardiovascular Events in Patients After an Acute Coronary Syndrome Restenosis, Stent Thrombosis, and Bleeding Complications - Navigating Between Scylla and Charybdis Prognostic Value of SYNTAX Score in Patients With Infarct-Related Cardiogenic Shock: Insights From the CULPRIT-SHOCK Trial Stent Thrombosis Risk Over Time on the Basis of Clinical Presentation and Platelet Reactivity: Analysis From ADAPT-DES

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.