Drug-Coated Balloon Percutaneous Coronary Intervention in ST- Elevation Myocardial Infarction (STEMI): A Novel Therapeutic Approach

Abstract

ST-elevation myocardial infarction (STEMI) is a life-threatening cardiovascular condition requiring immediate

revascularization. Percutaneous coronary intervention (PCI) with drug-eluting stents (DES) has been the standard treatment;

however, the long-term risks of in-stent restenosis (ISR), late stent thrombosis, and dual antiplatelet therapy (DAPT)

complications necessitate alternative approaches. Drug-coated balloon (DCB) technology has emerged as a promising

therapeutic strategy, offering advantages such as reduced foreign body implantation, homogenous drug delivery, and faster

vascular healing. DCBs deliver antiproliferative drugs directly to the vessel wall, minimizing neointimal hyperplasia and

restenosis. This review explores the efficacy, safety, and clinical outcomes of DCB-PCI in STEMI management. Additionally,

we compare DCBs with DES and discuss their potential role in high-risk patient groups, including those with small vessels and

bifurcation lesions. Challenges such as late lumen loss and the need for optimized patient selection criteria are also examined.

Finally, ongoing clinical trials and future perspectives on integrating DCBs into mainstream STEMI treatment protocols are

highlighted.