International Circulation: What is the latest status in preclinical research and clinical application of drug-eluting balloons? What kind of patients are the best candidates for drug-eluting balloons? Dr. Eeckhout: Drug-eluting balloons have been around for a while. If you go back to the paper of Scheller in the mid 2000s where we saw in preclinical work with a balloon in animals where there was a clear reduction in neointimal proliferation. Then, there came the first trials and the NEJM paper in 2006 by Scheller on a small randomized trial demonstrating the benefit of a DEB over a conventional balloon for restenosis. Therefore, the best indication for a DEB today is clearly in-stent restenosis. It appears that, although the evidence is still not very strong, that in the field of DES in-stent restenosis, which is usually very difficult to treat, this kind of technology seems to work very well. Some people use it in small vessels and bifurcations, but for me the mainstay of therapy with DEB is in-stent restenosis, and this pathology is quite frequent.
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