Clinical expert consensus document on drug-coated balloon for coronary artery disease from the Japanese Association of Cardiovascular Intervention and Therapeutics

Cardiovasc Interv Ther. 2023 Apr;38(2):166-176. doi: 10.1007/s12928-023-00921-2. Epub 2023 Feb 27.

Abstract

Drug-coated balloon (DCB) technology was developed to deliver the antiproliferative drugs to the vessel wall without leaving any permanent prosthesis or durable polymers. The absence of foreign material can reduce the risk of very late stent failure, improve the ability to perform bypass-graft surgery, and reduce the need for long-term dual antiplatelet therapy, potentially reducing associated bleeding complications. The DCB technology, like the bioresorbable scaffolds, is expected to be a therapeutic approach that facilitates the "leave nothing behind" strategy. Although newer generation drug-eluting stents are the most common therapeutic strategy in modern percutaneous coronary interventions, the use of DCB is steadily increasing in Japan. Currently, the DCB is only indicated for treatment of in-stent restenosis or small vessel lesions (< 3.0 mm), but potential expansion for larger vessels (≥ 3.0 mm) may hasten its use in a wider range of lesions or patients with obstructive coronary artery disease. The task force of the Japanese Association of Cardiovascular Intervention and Therapeutics (CVIT) was convened to describe the expert consensus on DCBs. This document aims to summarize its concept, current clinical evidence, possible indications, technical considerations, and future perspectives.

Keywords: Coronary artery disease; Drug-coated balloon; Percutaneous coronary intervention; Restenosis.

Publication types

  • Review

MeSH terms

  • Angioplasty, Balloon, Coronary* / adverse effects
  • Coated Materials, Biocompatible
  • Consensus
  • Coronary Artery Disease* / complications
  • Coronary Artery Disease* / surgery
  • Coronary Restenosis* / etiology
  • Coronary Restenosis* / prevention & control
  • Humans
  • Percutaneous Coronary Intervention* / adverse effects
  • Treatment Outcome

Substances

  • Coated Materials, Biocompatible