Drug-Eluting Balloons (DEBs) are conventional semi-compliant angioplasty balloons covered with an antirestenotic drug which is released into the vessel wall during inflation of the balloon, usually at nominal pressures with a specific minimal inflation time. The active substance on the Drug-Eluting Balloons should be lipophilic enough to have a high absorption rate through the vessel wall to compensate for the short period of contact between the inflated balloon and the vessel wall itself, and to maintain a sustained effect once released.
Percutaneous treatment of complex coronary lesions, such as small-vessel heart disease, diabetes and long diffuse disease, remain hampered by suboptimal results, even with the use of drug-eluting stents (DES). The DEB is an interesting emerging device in the field of heart disease that
optimises clinical outcomes in these specific lesions. The DEB may become a viable alternative treatment option for the inhibition of coronary restenosis and subsequent revascularisation, as it allows local release of a high-concentration antirestenotic drug, paclitaxel, into the coronary vessel without using a metal scaffold or durable polymers.
Several studies have already shown promising and consistent results in the treatment of in-stent restenosis. The DEB has demonstrated its added value compared with certain DES. Inspired by these results, an increasing number of studies have been started in different coronary lesion subsets to explore the value of the
DEB in a broader range of lesions. It will be interesting for cardiology associates to see whether the DEB will find more indications beyond in-stent restenosis treatment. Moreover, will all DEBs offer the same added value, or will there be differences in efficacy among the DEBs produced by the various manufacturers? As was the case in the development of DES, now the puzzle pieces have to be put together for DEB. Potentially more good news on the horizon for cardiology associates.
