Drug-coated balloon angioplasty in coronary artery disease: state of the art review

Drug-coated balloons (DCBs) provide a "leave-nothing-behind" revascularization strategy, delivering antiproliferative therapy without permanent implants. This review presents evidence on DCB performance across coronary indications. In in-stent restenosis and de novo disease, DCBs are associated with higher rates of repeat revascularization compared to drug-eluting stents (DES). In small vessel disease, DCBs achieve comparable or sometimes superior outcomes. In complex lesions or high-risk patients, dedicated studies demonstrate feasibility and signals of non-inferiority.