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2016 ACC/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines SGLT-2 Inhibitors and Cardiovascular Risk: An Analysis of CVD-REAL Novel developments in revascularization for left main coronary artery disease Tissue characterisation of atherosclerotic plaque in the left main: an in vivo intravascular ultrasound radiofrequency data analysis Evaluation and Management of Right-Sided Heart Failure: A Scientific Statement From the American Heart Association Poor R-wave progression as a predictor of sudden cardiac death in general population and subjects with coronary artery disease Clopidogrel Pharmacogenetics: State-of-the-Art Review and the TAILOR-PCI Study The spectrum of heart failure: value of left ventricular ejection fraction and its moving trajectories A pragmatic approach to the use of inotropes for the management of acute and advanced heart failure: An expert panel consensus Diuretic Therapy for Patients With Heart Failure JACC State-of-the-Art Review

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.