This systematic review is the second update of the systematic review "drug-eluting balloon (DEB)"
compiled in 2009, and first updated in 2013. The aim of this systematic review was to assess the efficacy and safety of percutaneous transluminal coronary angioplasty (PTCA) with drug-eluting balloon (DEB) compared to PTCA with uncoated balloon (UCB) or implantation of a drug-eluting stent (DES) for the treatment of instent restenosis (ISR), small coronary vessel disease (SVD), ostium stenosis and de-novo lesions of coronary vessels.

Current evidence suggests a benefit for PTCA with DEB vs. PTCA with UCB in ISR, but no difference in efficacy and safety of PTCA with DEB and DES implantation – the first line therapy recommended in current guidelines – in ISR or de-novo lesions. For SVD the current evidence is insufficient to assess the efficacy and safety of PTCA with DEB in comparison to DES implantation.

We recommend a re-evaluation for SVD in 2020. For ISR, de-novo lesions and ostium stenosis a re-evaluation is not recommended. Based on the current evidence, the inclusion of PTCA with DEB into the Austrian hospital benefit catalogue is not recommended.