title: An update on the clinical use of drug-coated balloons in percutaneous coronary interventions.
abstract: BACKGROUND
  Drug-coated balloons (DCB) promise to deliver anti-proliferative drugs and prevent restenosis leaving nothing behind. Although, randomized clinical trials have demonstrated their efficacy for the treatment of in-stent restenosis, clinical evidence supporting their use in other coronary applications is still lacking.
  
  
  METHODS
  This review summarizes the development status of clinically available DCB technologies and provides an update on the current data for their coronary use.
  
  
  CONCLUSIONS
  Current generation DCB prevent restenosis by delivering paclitaxel particles on the surface of the vessel wall. Although clinically available technologies share a common mechanism of action, important differences in pharmacokinetic behavior and safety profiles do exist. Future technological improvements include the development of coatings displaying: high transfer efficiency; low particle embolization potential; and alternative drug formulations. Optimized balloon-based delivery systems and drug encapsulation technologies also promise to improve the technical limitations of current generation DCB. Although proving clinical superiority against DES may prove to be difficult in mainstream applications (i.e., de novo), new generation DCB technologies have the potential to achieve a strong position in the interventional field in clinical settings in which the efficacy of DES use is not proven or justified (i.e., bifurcations).
authors.affiliation: a CRF-Skirball Center for Innovation , Orangeburg , NY , USA.
authors.forename: Yanping
authors.initials: Y
authors.lastname: Cheng
authors.affiliation: b Center for Interventional Vascular Therapy , Columbia University Medical Center , New York , NY , USA.
authors.forename: Martin B
authors.initials: MB
authors.lastname: Leon
authors.affiliation: a CRF-Skirball Center for Innovation , Orangeburg , NY , USA.
authors.forename: Juan F
authors.initials: JF
authors.lastname: Granada
mesh_terms: D023903:Coronary Restenosis / Q000517:prevention & control*; D054855:Drug-Eluting Stents; D006801:Humans; D017239:Paclitaxel / Q000008:administration & dosage*; D062645:Percutaneous Coronary Intervention / Q000379:methods*
chemical_list: D017239:Paclitaxel
keywords: Angioplasty; coronary artery disease; drug-coated balloon; in-stent restenosis paclitaxel