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用于冠状动脉疾病的药物涂层球囊:从理论到实践

Drug-Coated Balloons for Coronary Artery Disease: From Theory to Practice.

作者信息

Moumneh Mohamad B, Jamil Yasser, Nanna Michael G, Damluji Abdulla A

机构信息

Inova Center of Outcomes Research, 3300 Gallows Road, Falls Church, VA 22042, USA.

Yale University School of Medicine, New Haven, CT, USA.

出版信息

Curr Treat Options Cardiovasc Med. 2025 Dec;27(1). doi: 10.1007/s11936-025-01084-4. Epub 2025 Mar 19.

Abstract

PURPOSE OF REVIEW

The purpose of this work is to review the role of drug-coated balloons (DCBs) in contemporary coronary artery disease (CAD) management by focusing on its clinical indications and technical considerations, supported by updated insights from the International DCB Consensus Group.

RECENT FINDINGS

While percutaneous coronary intervention (PCI) and drug-eluting stents were initially the standard treatment for CAD, limitations such in-stent stenosis, neoatherosclerosis, and increased bleeding led to the development of the novel DCBs. These DCBs have become well established in treating various clinical cases such as in-stent restenosis, de-novo small-vessel disease, bifurcation lesions, large-vessel disease, high bleeding risk, acute coronary syndromes, and diabetes mellitus.

SUMMARY

For optimal DCB outcomes, functional assessments, careful lesion preparation, and patient selection are crucial for effective drug delivery and reduced complications. Ongoing innovations in drug formulations, balloon design, and delivery mechanisms, along with further trials, will expand DCBs' impact in CAD treatment.

摘要

综述目的

本研究旨在通过关注药物涂层球囊(DCB)的临床适应症和技术考量,并参考国际DCB共识小组的最新见解,来回顾其在当代冠状动脉疾病(CAD)管理中的作用。

最新发现

虽然经皮冠状动脉介入治疗(PCI)和药物洗脱支架最初是CAD的标准治疗方法,但诸如支架内狭窄、新生动脉粥样硬化和出血增加等局限性促使了新型DCB的发展。这些DCB在治疗各种临床病例方面已得到广泛应用,如支架内再狭窄、初发小血管病变、分叉病变、大血管病变、高出血风险、急性冠状动脉综合征和糖尿病。

总结

为了获得最佳的DCB治疗效果,功能评估、仔细的病变预处理和患者选择对于有效给药和减少并发症至关重要。药物配方、球囊设计和输送机制方面的持续创新,以及进一步的试验,将扩大DCB在CAD治疗中的影响。

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本文引用的文献

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J Am Heart Assoc. 2024 Dec 3;13(23):e036839. doi: 10.1161/JAHA.124.036839. Epub 2024 Nov 22.
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Drug-Coated Balloon Angioplasty of the Side Branch During Provisional Stenting: The Multicenter Randomized DCB-BIF Trial.
J Am Coll Cardiol. 2025 Jan 7;85(1):1-15. doi: 10.1016/j.jacc.2024.08.067. Epub 2024 Oct 28.
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Peripheral Drug-Coated Balloon for Coronary Drug-Eluting Stent In-Stent Restenosis: Off-Label, Off-Target.
J Soc Cardiovasc Angiogr Interv. 2024 Feb 20;3(3Part A):101306. doi: 10.1016/j.jscai.2024.101306. eCollection 2024 Mar.
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