Drug-coated balloons

Summary 

Drug-coated balloons (DCB) are gaining attraction worldwide for the treatment of peripheral and coronary lesions. The basic prerequisite for this therapy is the best possible lesion preparation. DCBs cannot replace drug-eluting stents, but will play an important role in the reduction of permanent implants in interventional vascular medicine in the future. 

Introduction 

Andreas Grüntzig introduced coronary angioplasty into clinical use in 1977 11. Gruntzig A. Transluminal dilatation of coronary-artery stenosis. Lancet. 1978;1:263 Link. For the field of coronary interventions, the introduction of stents represented a major milestone. Stenting overcomes the major limitations of balloon angioplasty, namely, acute recoil, dissections, abrupt vessel closure and longer-term negative vessel remodelling. However, restenosis may be accelerated due to continued or increased neointimal proliferation associated with the permanent implant. Local intravascular drug delivery by drug-eluting stents (DES) that elute paclitaxel, sirolimus, or their associated analogues have successfully addressed this cellular basis of restenosis in the coronary territory. However, delayed or incomplete re-endothelialisation with the need for long-term dual antiplatelet therapy (DAPT) to reduce the risk of stent thrombosis can limit the use of this technology. Sustained drug release seems to be essential for stent-based local drug delivery because of the inhomogeneous...