What are the potential limitations of drug coated balloons (DCBs) and possible ways to overcome.

ABSTRACT

In several independent randomized clinical studies, it has been shown that DCBs cause persistent clinically meaningful and statistically significant inhibition of restenosis in femoropopliteal arteries in comparison to percutaneous transluminal angioplasty with uncoated balloon catheters (1-6). The potential benefits of delivering an antiproliferative drug into the vessel wall using a balloon as transporter are manifold • Widespread applicability Balloon angioplasty is suitable for use in a wide range of lesions. The use of DCBs is technically less demanding and offers greater flexibility compared with stenting techniques. • Maintaining options Minimizing the use of durable implants is providing more options for following and complementary revascularization procedures. • Proven Efficacy Consistent, positive outcomes across studies and key subgroups have been demonstrated from the first preclinical studies to ongoing clinical trials Beside the enthusiasm carried along with this novel technique and questioning if DCBs will become standard-of-care-therapy for the superficial femoral artery (SFA), the potential limitations have to be discussed.