After decades of research, DCB has become the new concept of treatment of CAD and is increasingly used in ISR as well as in de novo lesions. Their efficacy and safety were proved for both in-stent restenosis (ISR), native small-vessel disease, and also other emerging indications like Large vessel disease, and high bleeding risk.

 All consecutive patients in our hospital who underwent DCB were prospectively included. We evaluated a consecutive series of 37 lesions in which Drug-Coated Balloons were used to treat De novo lesions and ISR. The study duration was from January 2023 to October 2023.

Between January 2023 and October 2023, 35 patients who underwent DCB angioplasty were included, representing 7.3% of all PCIs in our institution. A total of 37 lesions in 35 patients were treated.  The mean age was 59.8 years of which 80% were male. Risk factors analysis revealed hypertension in 68%, and diabetes in 74%. 14 patients had a history of previous PCI, and 1 had prior CABG.  Clinical presentation was stable angina in 20 patients and ACS in 15 patients. Distribution of treated arteries is as follows: left anterior descending coronary artery (LAD) in 10, left circumflex coronary artery (LCX) in 7, right coronary artery (RCA) in 7, Diagonal in 3, Ramus in 2, Obtuse Marginal (0M) in 3, LPDA in 1, RPDA in 3 and LIMA to LAD anastomotic site in 1.  The majority of the lesions (73%) were de-novo lesions and 27% were ISR. The reference vessel diameter and lesion length for the total population were 2.34 ± 0.69 mm and 20.62 ± 4.32 mm, respectively. Lesion preparation was done mostly with non-compliant balloons at nominal pressure (n=27) and cutting balloons (n=13) in the calcified and non-yielding lesion. Non-complaint balloons and cutting balloons together were used in 8 lesions. Intravascular Lithotripsy (IVL) was used in 1 type 4 ISR lesion. Angiographic success defined by residual lesion of < 20% by quantitative coronary analysis was achieved in all cases. Most of the dissection noted were Type A or Type B, non-flow limiting type. At 1-month follow-up detail clinical evaluation was done with ECG recording. No in-hospital or 30-day MACE was reported. 

This single-centre observational study with short-term follow-up, supports the concept of a DCB-only PCI strategy in suitable de novo and ISR coronary artery lesions.