{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T23:51:23Z","timestamp":1790207483118,"version":"4.1.0"},"reference-count":81,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T00:00:00Z","timestamp":1761350400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) is the most used revascularization strategy in current clinical practice. However, this approach is still associated with a non-negligible risk of adverse events, including late and very late in-stent restenosis (ISR) and stent thrombosis, even with newer-generation DESs. Notably, long stents and the use of overlapping stents have been consistently identified as independent predictors of both ISR and stent thrombosis. Drug-coated balloons (DCBs) have emerged as a viable alternative to DESs. Initially evaluated in specific clinical settings, such as small-vessel disease and ISR, DCBs have demonstrated promising results in the treatment of more complex coronary lesions and higher-risk patient populations, including elderly, diabetics and those at high bleeding risk. Their main advantage lies in avoiding permanent implantation of metallic struts and polymer coatings, thereby preserving coronary vasomotor function and promoting positive vessel remodeling and late lumen enlargement. As a result, a hybrid or blended revascularization strategy combining DESs and DCBs has gained increasing interest, offering the potential to harness the complementary benefits of both DESs and DCBs, while minimizing stent overlap and total stent length. Some studies have explored this approach, particularly for the treatment of diffuse coronary artery disease and bifurcation lesions. This narrative review aims to outline the pathophysiological rationale underlying a blended DCB\/DES approach and to summarize the currently available clinical evidence. Furthermore, we discuss future perspectives for optimizing the combination DCB and DES PCI in real-world practice.<\/jats:p>","DOI":"10.3390\/jcm14217576","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T09:16:24Z","timestamp":1761729384000},"page":"7576","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Blended Coronary Revascularization with Drug-Coated Balloon and Drug-Eluting Stent: A Narrative Review on Rationale, Clinical Evidence, and Future Perspectives"],"prefix":"10.3390","volume":"14","author":[{"given":"Filippo Luca","family":"Gurgoglione","sequence":"first","affiliation":[{"name":"DCB Academy, 20143 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman","family":"Murad","sequence":"additional","affiliation":[{"name":"DCB Academy, 20143 Milano, Italy"},{"name":"Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac Centre (MKCC), Road 4524, Block 945, Awali P.O. Box 101, Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Frazzetto","sequence":"additional","affiliation":[{"name":"DCB Academy, 20143 Milano, Italy"},{"name":"Coronary Center, University Hospitals Harrington Heart and Vascular Institute, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5808-7810","authenticated-orcid":false,"given":"Bernardo","family":"Cortese","sequence":"additional","affiliation":[{"name":"DCB Academy, 20143 Milano, Italy"},{"name":"Coronary Center, University Hospitals Harrington Heart and Vascular Institute, Cleveland, OH 44106, USA"},{"name":"Fondazione Ricerca e Innovazione Cardiovascolare, Via Ettore Ponti 49, 20143 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.1016\/S0140-6736(19)31997-X","article-title":"Percutaneous coronary intervention versus coronary artery bypass grafting in patients with three-vessel or left main coronary artery disease: 10-year follow-up of the multicentre randomised controlled SYNTAX trial","volume":"394","author":"Thuijs","year":"2019","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.jcin.2013.09.008","article-title":"PRODIGY Investigators. 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