Which of the following criteria must be met to treat an ISR lesion with a DCB?

• A. Stent expansion greater than 30% residual stenosis
• B. No flow-limiting dissection
• C. Adequate lumen area less than 80% of distal reference
• D. Length of dissection greater than 3 mm

Answer: (B)

To treat a restenosis (ISR) lesion with a drug-coated balloon (DCB), one of the critical criteria is the absence of flow-limiting dissection. Flow-limiting dissections can hinder proper blood flow and significantly affect the outcomes following the treatment. If a dissection is present that impedes blood flow, it may indicate a more complex situation that could necessitate different therapeutic approaches rather than simply using a DCB.

In the context of treating ISR, ensuring that the vessel can accommodate the DCB and that the healing process after treatment is unhindered by such complications is essential for achieving optimal results. A DCB aims to deliver medication to the vessel wall to prevent restenosis, and the presence of a flow-limiting dissection could compromise the effectiveness of this treatment.