Cage‐Free Chronic Occlusion PCI: Multivessel Total and Subtotal Occlusion Treatment With Drug Coated Balloon Angioplasty

ABSTRACT Drug‐coated balloon (DCB) catheters offer an alternative to drug‐eluting stents (DES) by delivering anti‐proliferative drugs directly to vessel walls, avoiding implantation of a permanent metallic structure. While DCBs have shown efficacy for in‐stent restenosis, evidence for their application in de novo coronary disease and chronic total occlusion (CTO) PCI is growing. We present a case of a 49‐year‐old male with multivessel chronic total and subtotal occlusions who had complete percutaneous revascularisation using a DCB only strategy. Each lesion had unique characteristics involving its length and location, bifurcation anatomy, and vessel diameter for which this stent‐free approach was favored. DCB use in CTO PCI may be promising in select cases and lesions, and further studies are warranted to ascertain long‐term efficacy in this setting.