The biblical admonition not to put “new wine into old wineskins” was to warn against trying to force new ideas onto an old established system. But what if the system is completely new and old ideas might be useful again, “old wine in new bottles”? This rather stretched metaphor came to me at the recent CRT meeting in Washington, DC where many talks on drug coated balloons (DCB) were presented. During a joint session of the International Society for Cardiovascular Translational Research (ISCTR) and CRT, Antonio Colombo made the argument that DCBs might be used much more widely than just for in-stent restenosis or small vessels. This rather radical idea to treat an adequate angioplasty result without stenting is being pursued by some of our colleagues, mostly outside the United States. The concept that a well-dilated vessel with intravascular imaging evidence of a good result does not need a device left in place and the dream that, with nothing left behind the vessel will have a better long-term future, is a dramatic departure from our current system, “stenting”. But is our current system really just stenting? We call it that, but we should remember that stents solved only one problem, acute closure, and our current system is much more; including imaging guided lesion preparation, imaging guided optimization and application of a drug that inhibits excessive neointimal formation and prevents restenosis. Yes, the stent is the carrier of that drug, but does it have to be? If this new system of PCI without a stent is to be considered, are there any old lessons that need to be revisited?