Drug-coated Balloon : A Superb Alternative To Coronary Stents

Abstract

The evolution of interventional cardiology has witnessed a paradigm shift in the management of coronary artery
disease (CAD). Among the arsenal of interventions, coronary stents have been a cornerstone, providing mechanical
support and reducing restenosis rates. However, concerns persist regarding stent-related complications such as
in-stent restenosis, late stent thrombosis & hazards of bleeding due to use of long dual antiplatelet (DAPT). In
recent years, the emergence of drug-coated balloon (DCB) has introduced a promising alternative approach for
the treatment of CAD. DCB offer a unique mechanism of action, delivering antiproliferative drugs directly to the
vessel wall without leaving a permanent implant. This characteristic eliminates concerns related to stent thrombosis
and the need for long-term DAPT. Furthermore, DCB preserve vessel anatomy and vasomotion, potentially enabling
future revascu- larization options. Clinical trials and real-world data have demonstrated the efficacy of DCB in
various coronary lesions, including small vessels and in-stent restenosis. This abstract provides an overview of
the advantages of DCB over traditional coronary stents and highlights key clinical evidence supporting their use.
Additionally, it discusses the economic implications and patient-centered outcomes associated with DCB therapy.
Despite these advantages, challenges such as device delivery and optimal drug formulations remain areas of
ongoing research and development. In conclusion, DCB represent a superb alternative to coronary stents in
selected patients with CAD, offering comparable efficacy while mitigating stent & antiplatelet related complications.
As technology continues to advance, further refinements in DCB design and drug delivery systems hold the
potential to revolutionize the landscape of coronary intervention, providing safer and more effective treatment
options for patients with CAD.

Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 151