What are the barriers to the use of drug - eluting balloons ? editorial

Department of Cardiology, Heart Hospital, 16–18 Westmoreland Street, London, W1G 8PH, UK In percutaneous coronary interventions the main risk of restenosis and, despite the advent of drugeluting stents, it still poses a significant problem [1]. The concept behind drug-eluting balloons (DEBs) is local drug administration and sustained release of antiproliferative drugs without a permanent stent and with homo genous transfer of drugs to the vessel wall [2]. This shorter duration of drug release and the avoidance of implanting a permanent ‘foreign body’ may facilitate vascular healing, reduce hypersensitivity reactions to the foreign body, reduce the risk of stent thrombosis [3] and, thus, reduce the duration of intensive antiplatelet therapy, which is needed after a stent implantation. However, there are certain limitations to DEBs that we will discuss in the article, such as the relatively high rate of bail-out stenting in case of unsatisfactory angiographic results, significant heterogeneity among different DEBs and limited data from clinical trials.