Page 7 - Read Online

Onea et al. Vessel Plus 2023;7:13 Vessel Plus
DOI: 10.20517/2574-1209.2023.11

Review Open Access

Diffuse coronary artery disease management with

drug-coated balloons

1
1
Horea-Laurentiu Onea 1 , Florin-Leontin Lazar , Dan-Mircea Olinic , Bernardo Cortese 2,3,4
1
Medical Clinic Number 1, “Iuliu Ha ieganu” University of Medicine and Pharmacy, Cluj- Napoca 400012, Romania.
2
Fondazione Ricerca e Innovazione Cardiovascolare, Milano 20123, Italy.
3
DCB Academy, Milano 20123, Italy.
4
Cardioparc, Lyon 69230, France.
Correspondence to: Dr. Bernardo Cortese, Fondazione Ricerca e Innovazione Cardiovascolare, Milano 20123, Italy. E-mail:
bcortese@gmail.com
How to cite this article: Onea HL, Lazar FL, Olinic DM, Cortese B. Diffuse coronary artery disease management with drug-coated
balloons. Vessel Plus 2023;7:13. https://dx.doi.org/10.20517/2574-1209.2023.11

Received: 9 Mar 2023 First Decision: 21 Jun 2023 Revised: 26 Jun 2023 Accepted: 4 Jul 2023 Published: 12 Jul 2023
Academic Editor: Manel Sabaté Copy Editor: Pei-Yun Wang Production Editor: Pei-Yun Wang

Abstract
Drug-coated balloons (DCB) have emerged as a valid alternative for drug-eluting stents in the treatment of in-stent
restenosis and de-novo lesions in small vessels. In the past years, a significant effort has been made to investigate
the role of this strategy in larger vessel disease, with promising preliminary results being reported for several
clinical scenarios, including complex lesions, such as bifurcations, chronic total occlusions and diffuse, long lesions.
A DCB strategy appears to be of significant interest in diffuse coronary disease, as the total stent length represents
an independent predictor for target-vessel failure and a surgical approach does not seem to improve mid- and long-
term results compared to optimal medical treatment. Several studies have investigated the safety and efficacy of a
non-stent-based approach in this complex setting, and as promising results have been reported, it is fair to assume
that reducing the amount of implanted metal in diffusely affected vessels could become the standard of care for
these patients if a full or blended therapy with DCB is adopted. However, long-term results from large-scale studies
are awaited to confirm these preliminary and intriguing results.

Keywords: Drug-coated balloon, diffuse coronary artery disease, long coronary lesions

INTRODUCTION
Percutaneous coronary interventions (PCI) have continuously been refined in the past decade, mainly by

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

www.vpjournal.net