Drug-Coated Balloon: Perspective of Current Evidence

Abstract

Context: The drug-coated balloons (DCB) are angioplasty balloons that have a coating of an anti-proliferative drug which is delivered to the vessel wall when the balloon is inflated at specific low pressures for a set amount of time and a relatively new Percutaneous Coronary Intervention (PCI) technique in the "stentless" coronary approach. This review summarizes current evidence on DCBs in coronary interventions, emphasizing their established use in in-stent restenosis (ISR) and small vessel disease, while exploring emerging applications in large vessels, bifurcation lesions, diffuse coronary artery disease (CAD), and high bleeding risk patients. Evidence Acquisition: This narrative review was conducted based on recent literature on DCB. A literature search was performed using the keywords "drug coating balloon," "drug coating stent," and "indication." Articles published in English between 2015 and 2025 were included, while those with incomplete data, irrelevant content, or without full-text access were excluded. Results: Drug-coated balloons could be useful for cases where drug-eluting stents (DES) are restricted. It might also offer a fresh choice for independent balloon angioplasty. This approach replaces DES and bioresorbable scaffolds (BRS). Drug-coated balloons can be used for ISR, small and large vessel lesions, bifurcation lesions, long diffuse disease, acute coronary syndromes, and high bleeding risk patients. Conclusions: These cases can use DCB as a therapeutic option compared to DES, showing that DCB is effective and safe.