SCAI 2026 Sirolimus-Eluting Balloons in Coronary PCI: Key Insights from Recent Evidence-Discussion 1

Video Transcription

Video Summary

The discussion focused on drug-coated/drug-eluting balloon (DCB/DEB) use in de novo coronary disease and in-stent restenosis (ISR). Speakers emphasized that lesion preparation is critical for DCB success, including specialty balloons and adequate expansion, while noting that the impact of calcium modification versus stenting is uncertain. A learning curve was highlighted: early operators had more crossover to stenting, but similar clinical outcomes. The panel discussed trial design, arguing that strategy trials and device comparisons answer different questions. Imaging, especially IVUS, was viewed as helpful in judging vessel size, dissection severity, and whether bailout stenting is needed, though angiographic criteria often guided decisions. They also addressed vessel size, acute coronary syndrome substudies, and concerns about distal embolization, with no clear clinical signal of harm. Overall, the session supported careful preparation, conservative bailout stenting, and selective DCB use in appropriately chosen lesions.

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Keywords

drug-coated balloon

drug-eluting balloon

in-stent restenosis

lesion preparation

intravascular ultrasound