The **AGENT DCB STANCE** study is looking at how safe and effective a new treatment, the AGENT Drug-Coated Balloon (DCB), is compared to the usual treatment for blocked heart arteries. In this study, "de Novo Coronary Lesions" means new blockages in the heart's blood vessels. These blockages can stop blood from reaching the heart muscle, which can be serious. The study compares using a Drug-Coated Balloon (DCB) to a common method called Percutaneous Coronary Intervention (PCI), which often uses a small mesh tube called a stent to open up blocked arteries. The study is open-label, meaning both doctors and patients know which treatment is used. * **Participation Requirements:** Participants must be 18+ and agree to follow study rules. Women must use reliable birth control. * **Exclusion Criteria:** People with serious health issues, recent heart procedures, or certain heart conditions can't join. * **Study Duration:** The study requires ongoing follow-up. Participants need to understand the procedures and give written consent. This study aims to help doctors find better ways to treat heart artery blockages.