PERSPECTIVE article
Front. Cardiovasc. Med.
Sec. Coronary Artery Disease
This article is part of the Research TopicNew Perspectives on Drug-coated Balloons (DCB) For Treatment of Acute and Chronic Coronary Artery DiseaseView all 4 articles
Safety aspects of denovo DCB-only PCI – a practical checklist and a simplified revised dissection classification
Provisionally accepted
Natasha Corballis1*
Ioannis Merinopoulos2
Rajkumar Natarajan1Tharusha Gunawardena3
Upul Wickramarachchi2
Vass Vassiliou1
Antonio Colombo4Bruno Scheller5
Simon Eccleshall2- 1Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom
- 2Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom
- 3Watford General Hospital, Watford, United Kingdom
- 4IRCCS Humanitas Research Hospital, Rozzano, Italy
- 5Saarland, Saarbrücken, Germany
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There is increasing use of drug coated balloons (DCB) in de novo coronary disease based on an ever-expanding evidence base. However, DCB-only angioplasty requires a slightly modified lesion preparation strategy to ensure an optimal angioplasty result and to minimise the risk of vessel threatening dissection. We discuss the importance of optimal lesion preparation and vessel safety based on clinical and angiographic findings as well as appropriate DCB selection and deployment. We outline a new and simplified classification of dissections of those that are safe to leave (type 1) and those that should be modified or stented (type 2). We also present these in a simple graphical format. Finally, we provide a checklist approach to the complete process This review article will facilitate an acceleration of the learning curve of DCB-only percutaneous coronary intervention (PCI), highlighting the importance and understanding of lesion preparation and dissection assessment and above all ensuring patient safety throughout. We hope this will facilitate the adoption of safe DCB-only PCI.
Keywords: Drug coated balloon angioplasty, lesion preparation, coronary dissection, PCI, dissection classification
Received: 27 Jun 2025; Accepted: 28 Oct 2025.
Copyright: © 2025 Corballis, Merinopoulos, Natarajan, Gunawardena, Wickramarachchi, Vassiliou, Colombo, Scheller and Eccleshall. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Natasha Corballis, natasha.corballis@nnuh.nhs.uk
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