Department of Cardiology, Cardiovascular Center, Fujita Health University Hospital, 1-98 Dengaku, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
Division of Cardiology, Teikyo University Hospital, Tokyo, Japan.
Cardiovasc Interv Ther. 2023 Apr;38(2):166-176. doi: 10.1007/s12928-023-00921-2. Epub 2023 Feb 27.
Drug-coated balloon (DCB) technology was developed to deliver the antiproliferative drugs to the vessel wall without leaving any permanent prosthesis or durable polymers. The absence of foreign material can reduce the risk of very late stent failure, improve the ability to perform bypass-graft surgery, and reduce the need for long-term dual antiplatelet therapy, potentially reducing associated bleeding complications. The DCB technology, like the bioresorbable scaffolds, is expected to be a therapeutic approach that facilitates the "leave nothing behind" strategy. Although newer generation drug-eluting stents are the most common therapeutic strategy in modern percutaneous coronary interventions, the use of DCB is steadily increasing in Japan. Currently, the DCB is only indicated for treatment of in-stent restenosis or small vessel lesions (< 3.0 mm), but potential expansion for larger vessels (≥ 3.0 mm) may hasten its use in a wider range of lesions or patients with obstructive coronary artery disease. The task force of the Japanese Association of Cardiovascular Intervention and Therapeutics (CVIT) was convened to describe the expert consensus on DCBs. This document aims to summarize its concept, current clinical evidence, possible indications, technical considerations, and future perspectives.
药物涂层球囊（DCB）技术的发展旨在将抗增殖药物递送至血管壁，而不会留下任何永久性假体或持久聚合物。没有异物可以降低非常晚期支架失败的风险，提高旁路移植手术的能力，并减少长期双联抗血小板治疗的需求，从而潜在地减少相关出血并发症。DCB 技术，与生物可吸收支架一样，有望成为一种促进“无遗留物”策略的治疗方法。尽管新一代药物洗脱支架是现代经皮冠状动脉介入治疗中最常见的治疗策略，但 DCB 在日本的使用正在稳步增加。目前，DCB 仅适用于治疗支架内再狭窄或小血管病变（<3.0mm），但对于更大血管（≥3.0mm）的潜在扩展可能会加速其在更广泛病变或阻塞性冠状动脉疾病患者中的使用。日本心血管介入治疗协会（CVIT）的专家组召开会议，描述了关于 DCB 的专家共识。本文旨在总结其概念、现有临床证据、可能的适应证、技术注意事项和未来展望。
