Advances in drug-coated balloons for the treatment of coronary artery de novo large-vessel lesions

J Int Med Res. 2025 Jun;53(6):3000605251342671. doi: 10.1177/03000605251342671. Epub 2025 Jun 28.

Abstract

The incidence and mortality of coronary heart disease are increasing annually, and the disease is now one of the leading causes of death in China. Percutaneous coronary intervention has become the preferred approach for treating coronary artery disease. The use of a drug-coated balloon is a new treatment strategy for coronary artery disease that has been shown to be safe and effective in intravascular restenosis, bifurcation disease, and small-vessel disease, and this approach has been extended to other indications, such as large-vessel coronary artery disease. However, some experts believe that the intima muscularis fibrosa of large vessels is thick. After dilation of large vessels with drug-coated balloons, elastic contraction may occur. Additionally, the use of drug-coated balloons cannot prevent the occurrence of vessel dissection; therefore, their use for treating large-vessel coronary disease remains controversial. This review has aimed to discuss the findings of clinical trials demonstrating the efficacy and safety of drug-coated balloons for the treatment of coronary artery de novo large-vessel lesions.

Keywords: Coronary artery disease; diabetes; drug-coated balloon; drug-eluting stent; large-vessel lesions; small-vessel lesions.

Publication types

  • Review

MeSH terms

  • Angioplasty, Balloon, Coronary* / instrumentation
  • Angioplasty, Balloon, Coronary* / methods
  • Coated Materials, Biocompatible*
  • Coronary Artery Disease* / pathology
  • Coronary Artery Disease* / surgery
  • Coronary Artery Disease* / therapy
  • Coronary Vessels* / pathology
  • Coronary Vessels* / surgery
  • Drug-Eluting Stents
  • Humans
  • Percutaneous Coronary Intervention* / methods

Substances

  • Coated Materials, Biocompatible