Premium
Treatment of drug‐eluting stent restenosis: Comparison between drug‐eluting balloon versus second‐generation drug‐eluting stents from a retrospective observational study
Author(s) -
Basavarajaiah Sandeep,
Naganuma Toru,
Latib Azeem,
Sticchi Alessandro,
Ciconte Giuseppe,
Panoulas Vasilis,
Chieffo Alaide,
Montorfano Matteo,
Carlino Mauro,
Colombo Antonio
Publication year - 2016
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.26368
Subject(s) - medicine , drug , drug eluting stent , restenosis , observational study , retrospective cohort study , balloon , coronary restenosis , cardiology , stent , pharmacology
Objectives To compare drug‐eluting balloons (DEBs) versus second‐generation DES in the treatment of drug‐eluting stent restenosis (DES‐ISR). Background The optimal treatment of DES‐ISR remains unclear. Several modes of treatment ranging from plain‐old balloon angioplasty to repeated use of DES have yielded disappointing results. DEBs are increasingly been used in restenotic lesions; however, their use in DES‐ISR is less established. Methods We evaluated all procedures between 2009 and 2011, involving DES‐ISR that were treated either with DEB or second‐generation DES. The measured end‐points during the follow‐up period were cardiac‐death, target‐vessel MI, TLR, TVR, and MACE defined as composite of cardiac‐death, TV‐MI, and TVR. Results Two hundred and forty‐seven patients (302 lesions) with DES‐ISR were treated with either DEB (81 patients; 104 lesions) or second‐generation DES (166 patients; 198 lesions). The mean age of patients was 66.1 ± 9.4 years. There were higher numbers of patients with diabetes in the DEB group (DEB 47% vs DES 33%; p = 0.03). The mean length of DEB was significantly longer than the DES (35.4 vs 19.8 mm; p < 0.001). During the 12‐month follow‐up, there were no significant differences in the MACE rates (12.3% vs 8.4%; p = 0.3) and TLR rates (9.9% vs 7.8%; p = 0.6) between DEB and DES, respectively. On the multivariate analysis, use of DEB or DES was not the predictor of MACE (hazard ratio: 0.84, 95% CI: 0.46–1.85; p = 0.6). There were no cases of definite or probable stent thrombosis in either group. Conclusion There were no significant differences in the clinical outcomes between DEB and second‐generation DES in the treatment of DES‐ISR. These results should encourage operators to consider DEB in the treatment of DES‐ISR, which offers certain advantages over DES. © 2015 Wiley Periodicals, Inc.