Angioplasty: Drug-Eluting Stents Or Drug-Coated Balloons


As discussed in an earlier Blog that an Angioplasty is a minimally invasive procedure that can improve blood flow by widening or unblocking a heart-related artery.

A little, specially-made metal tube called a Stent is what a doctor uses to keep a blocked route open. Depending on where it is inserted, the stent resumes blood flow or other fluids. Metal mesh, Cloth, Silicone, or a combination of materials can all be used to make Stents. Metal mesh is utilised to make the stents used in coronary arteries. Larger arteries like the aorta are treated with fabric stents, sometimes known as stent grafts. Silicone is a common material for the stenting utilised in the lungs’ airways.

To prevent a blocked artery from closing, stenting devices can also be coated with medications. There are predominantly two distinct types of stents, such as:

  1. Bare Metal Stents (BMS): These were employed at first, made out of stainless steel was used to make the first stents that were approved for use in heart arteries. Cobalt-chromium alloy has been used to make “second generation” bare-metal stents more recently.
  1. Drug-Eluting Stents (DES): Because bare-metal stents have a higher risk of restenosis, or the development of tissue into the stent that causes artery narrowing, drug-eluting stents (DES) are frequently chosen over them. After the DES is inserted into the coronary artery, it gradually delivers medications to stop the arteries from developing restenosis.

Are there any Side-Effects of Stents?

Stents were first maintained on hand to cure dissections and prevent blood arteries from suddenly closing. Stent implantation entails certain dangers, including:

  • In-stent Re-stenosis (Re-narrowing of artery or Recurrence of block inside the stent)
  • Stent Thrombosis (Clotting inside the stent)
  • Stent Deformation and fracture
  • Infection & Kidney Damage
  • Bleeding due to artery damage at the treatment site leading to re-narrowing by clotting of blood.
  • Allergic reactions
  • Blood Vessel Damage &
  • Stroke

The stented arterial segment no longer experiences physiological vasomotion as usual, and the artery may potentially undergo detrimental remodelling. In these situations, despite the possibility of drug-induced bleeding, aspirin and other antiplatelet/anticoagulant medications are administered for several months after the procedure.

Revolutionary Coronary Angioplasty: Drug-Coated Balloon (DCB)

Recently, Drug Coated Balloons (DCB) using Sirolimus drug is safe and effective treatment option, emerged for coronary artery disease. Drug-Coated Balloon (DCB) is a cutting-edge, metal-free therapy that involves coating a balloon with an anti-proliferative medication like Sirolimus to treat vascular diseases and promote healing.

When the balloon is inflated, the medication enters the various layers of the blood artery, promotes healing, and eliminates potential blockages. Using Nanolute technology, the medication is coated onto the balloon to improve drug adhesion to the surface and to effectively deliver the drug to the deepest layer of the vessel. The vessel’s typical physiology is maintained and may even result in late luminal gain (increased diameter of the artery vessel).

  • No more stent thrombosis (clotting inside the stent), stent deformation and breakage, or prolonged blood-thinner medication needed.
  • DCB benefits high bleeding risk patients who require surgical treatment after angioplasty.
  • DCB avoids permanent implantation, promoting quicker recovery of the vessel wall.
  • It doesn’t leave any residual foreign material inside your artery.
  • Drug-coated balloons either don’t require blood-thinning drugs or require for a shorter time than other stents.
  • This ground-breaking technology has revolutionized vascular treatment with exceptional safety.

In India, known as the “Diabetic Capital of the World,” many people suffer from diabetic diffuse coronary artery disease and have smaller-calibre blood arteries. In these circumstances, DCB is a safe alternative.. For Indian individuals with diabetes and coronary artery disease, DCB is very promising. FDA is also keenly looking at this technology with the product already receiving IDE in select indications.


Around the world, there are several active clinical trials with DCB to ascertain its long-term efficacy, in comparison to other stents, and usefulness in diverse clinical scenarios. Because inserting long and small-diameter stents carry a higher risk of clotting and blocking recurrence inside the stent, drug-coated balloons are a blessing for patients. When used properly, drug-eluting stents (DES) and drug-coated balloons are complementary. Hence, DCB has expanded the potential for coronary interventions.