Coronary Drug-Coated Balloons as Brief-Contact Drug-Delivery Platforms: Engineering, Tissue Pharmacokinetics, and Angiographic/Imaging Response

Background and Objectives: Coronary drug-coated balloons (DCBs) deliver antiproliferative therapy during a single inflation without leaving a permanent scaffold or implanted drug reservoir. Their performance therefore depends on preservation of the coating during delivery, efficient vessel-wall transfer, and sufficient tissue exposure after balloon removal. This review critically examines the evidence for platform engineering, tissue exposure, and angiographic or intravascular imaging response. Materials and Methods: This narrative review synthesized English-language experimental, pharmacokinetic, imaging, and clinical evidence identified through the original PubMed, Scopus and Google Scholar searches and a documented PubMed search during revision on 9 September 2026. Exact queries, record dispositions and descriptive study appraisals are supplied; conference abstracts, preprints and unpublished data were excluded.