Drug-coated Balloons or Drug-eluting Stents - Determining an Optimum Strategy for Patients with High Bleeding Risk.

he management of patients who require percutaneous coronary intervention and are at high risk of bleeding continues to be challenging; balancing thrombotic risk versus bleeding risk to determine the safest duration of dual antiplatelet therapy (DAPT). With recent efforts to determine the safety of 1 month of DAPT after implantation of a drug-eluting stent, drug-coated balloons (DCBs) have also been explored, as both have been shown superior to bare-metal stents, which have historically been used for patients with high bleeding risk. We sought to review the literature surrounding the safety profile and bleeding events with both DCBs and drug-eluting stents, and conclude that while both offer safety of cessation of DAPT after 1 month, DCBs offer lower major adverse cardiovascular events.