Drug-coated balloon angioplasty for coronary and peripheral artery disease: latest evidence and clinical indications.

Drug-coated balloons (DCBs) are devices used for the treatment of both coronary artery disease (CAD) and peripheral artery disease (PAD). One of the hypothesized advantages of DCB angioplasty over stent implantation is that DCB angioplasty does not result in the presence of a permanent metallic scaffold in the vessel wall. However, DCB angioplasty also has some important limitations, such as a potentially lower efficacy compared with other modalities; therefore, the role of DCBs in the treatment of CAD and PAD is not fully defined. Over the past 20 years, many clinical trials have been performed to investigate the use of these devices for a variety of indications. In this Review, we describe the device design and mechanism of action of DCBs and discuss important procedural considerations for successful DCB use. We summarize the scientific and clinical evidence for DCB angioplasty in CAD and PAD. In addition, we highlight the recommendations for DCB use in clinical practice guidelines and provide perspectives on the potential future role that DCB angioplasty might have in the treatment of CAD and PAD.