title: Drug-eluting balloons in coronary interventions: the quiet revolution?
abstract: Drug-eluting balloons (DEB) may be considered as a 'quiet revolution' in percutaneous coronary interventions. Early-generation DEB eluting paclitaxel proved to be very effective in animal models to reduce neointimal hyperplasia. Areas covered: Review of DEB efficacy in patients with coronary de novo lesions and in-stent restenosis (ISR). Expert opinion: Many randomized clinical trials and meta-analyses have demonstrated the value of DEB in patients with ISR. In this setting, DEB are safe and effective with clinical and angiographic results superior to plain balloon angioplasty and at least equivalent to first generation drug-eluting stents (DES). In selected 'de novo' lesions (bifurcation lesions, small vessels, diffuse disease, myocardial infarction) DEB represent an attractive alternative although additional evidence in these 'niche' indications is still required before a widespread clinical utilization can be recommended. Recently, new generation DEB have become available, offering interesting new possibilities (paclitaxel and also sirolimus) for coronary interventions. Further studies are required to compare the results of novel generation DEB with those of second-generation DES.
authors.affiliation: a Department of Cardiology , Hospital Universitario de La Princesa , Madrid , Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Alfonso
authors.affiliation: a Department of Cardiology , Hospital Universitario de La Princesa , Madrid , Spain.
authors.forename: Marcos
authors.initials: M
authors.lastname: García-Guimaraes
authors.affiliation: a Department of Cardiology , Hospital Universitario de La Princesa , Madrid , Spain.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Navarrete
authors.affiliation: a Department of Cardiology , Hospital Universitario de La Princesa , Madrid , Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Cuesta
authors.affiliation: a Department of Cardiology , Hospital Universitario de La Princesa , Madrid , Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Bastante
authors.affiliation: a Department of Cardiology , Hospital Universitario de La Princesa , Madrid , Spain.
authors.forename: Amparo
authors.initials: A
authors.lastname: Benedicto
authors.affiliation: a Department of Cardiology , Hospital Universitario de La Princesa , Madrid , Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Rivero
authors.affiliation: b Department of Cardiology , A.O. Fatebenefratelli , Milano , Italy.
authors.forename: Bernardo
authors.initials: B
authors.lastname: Cortese
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D000818:Animals; D023903:Coronary Restenosis / Q000628:therapy*; D054855:Drug-Eluting Stents; D006801:Humans; D017239:Paclitaxel / Q000008:administration & dosage; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D020123:Sirolimus / Q000008:administration & dosage; D016896:Treatment Outcome; D050257:Tubulin Modulators / Q000008:administration & dosage
chemical_list: D050257:Tubulin Modulators; D017239:Paclitaxel; D020123:Sirolimus
keywords: In-stent restenosis; drug-coated balloon; optical coherence tomography; stents