药物涂层球囊(DCB)技术被开发用于将抗增殖药物递送至血管壁而不留下任何永久性假体或耐用聚合物。没有异物可以减少非常晚的支架失败的风险,提高进行搭桥手术的能力,减少长期双重抗血小板治疗的需要,可能减少相关的出血并发症。DCB技术,像生物可吸收的支架,预计将是一种治疗方法,有助于“不留任何东西”的策略。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,DCB的使用在日本稳步增长。目前,DCB仅适用于支架内再狭窄或小血管病变(<3.0mm)的治疗,但较大血管(≥3.0mm)的潜在扩张可能会加快其在更广泛的病变或阻塞性冠状动脉疾病患者中的使用。日本心血管干预和治疗学协会(CVIT)的工作组被召集来描述关于DCB的专家共识。本文件旨在总结其概念,目前的临床证据,可能的适应症,技术考虑,和未来的前景。
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.