Clinical application and expansion of paclitaxel-coated balloons in coronary atherosclerotic disease

Drug-coated balloon angioplasty has become one of the important means of interventional treatment for atherosclerotic cardiovascular diseases, and its application in clinical practice is becoming more and more common. Although several expert consensuses and a small number of scattered guideline recommendations have been issued, there is a lack of comprehensive and systematic guideline guidance. However, relevant clinical research and practice are still making continuous progress. This article reviews the clinical research progress of the indications for the treatment of coronary artery stenosis with paclitaxel drug-coated balloons, focusing on introducing its application overview and techniques in in-stent restenosis, bifurcation lesions, new lesions in large and small blood vessels, acute and chronic coronary syndromes and other situations, the management of special complications, and the dual antiplatelet strategy after drug balloon angioplasty, revealing new perspectives on the use of drug-coated balloons in different coronary artery disease scenarios. This article also discusses the cellular and molecular mechanisms related to the anti-atherosclerotic and anti-restenosis effects of paclitaxel, with the hope of providing direct guidance for the daily clinical practice of cardiologists and interventionalists.