Drug-Coated Balloons in Percutaneous Coronary Intervention for Complex Bifurcation Lesions

Abstract

Complex coronary bifurcation lesions represent one of the most demanding challenges in percutaneous coronary intervention (PCI). Despite advances in drug-eluting stent (DES) technology and bifurcation-specific techniques, restenosis and stent-related complications remain more prevalent in bifurcation lesions. Drug-coated balloons (DCBs), which deliver antiproliferative medication without permanent scaffolding, have emerged as a promising tool, particularly for side-branch treatment and stent-less strategies. This comprehensive review examines current evidence, mechanistic rationale, procedural techniques, clinical outcomes and future directions of DCB usage in complex bifurcation PCI.