The future of sirolimus-coated balloon use in percutaneous coronary intervention

Paclitaxel drug-coated balloons (DCBs) have become a mainstay for treatment of coronary in-stent restenosis (ISR) for more than a decade in Europe, more recently in Asia, and are now available for this indication in the United States12. More recently, there has been a surge in interest in exploring the utility of DCBs in de novo coronary disease, as a means of potentially averting the year-on-year growth in adverse events attributable to stented vessels3. In addition, a number of manufacturers have invested in the development of new DCBs employing non-paclitaxel active ingredients, most commonly sirolimus. With these developments come important questions about the use of DCBs in coronary disease: in which lesions should DCBs be used, and which DCBs are most effective for use?

In this issue of EuroIntervention, Scheller et al aim to address the latter question by comparing rates of late lumen loss (LLL) between patients with de novo lesions who received paclitaxel-coated balloon (PCB) versus sirolimus-coated balloon (SCB) therapy (the SeQuent SCB [B. Braun])4. The authors found no significant difference in LLL between patients who...