Comparison of 7-Year, Real-World Clinical Outcomes between Drug-Coated Balloon Angioplasty versus Drug-Eluting Stent Implantation in Patients with Drug-Eluting Stent In-Stent Restenosisopen access
- Authors
- Kim, Minsu; Jang, Albert Youngwoo; Lee, Joonpyo; Seo, Jeongduk; Shin, Yong Hoon; Oh, Pyung Chun; Suh, Soon Yong; Lee, Kyounghoon; Kang, Woong Chol; Han, Seung-Hwan
- Issue Date
- Jul-2023
- Publisher
- MDPI
- Keywords
- in-stent restenosis; drug-eluting balloon; drug-eluting stent
- Citation
- JOURNAL OF CLINICAL MEDICINE, v.12, no.13
- Journal Title
- JOURNAL OF CLINICAL MEDICINE
- Volume
- 12
- Number
- 13
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/88651
- DOI
- 10.3390/jcm12134246
- ISSN
- 2077-0383
- Abstract
- There are no data available comparing the real-world, long-term clinical outcomes of drug-eluting balloon (DEB) angioplasty and drug-eluting stent (DES) implantation in DES in-stent restenosis (ISR) lesions. We aimed to compare the real-world, long-term data available between DEBs and DESs in DES-ISR lesions. We analyzed consecutive DES-ISR lesions (225 lesions from 205 patients; male: 66.3%; mean age: 62.4 years) treated with either DEB or DES. The primary endpoint was target lesion revascularization (TLR), and the primary safety endpoint was the lesion-oriented composite outcome (LOCO). The LOCO is composed of cardiac death, myocardial infarction, and target lesion thrombosis during follow-up. During the 7-year follow-up period, TLR did not differ significantly between the DEB (n = 108) and the DES groups (n = 117) (HR: 1.07; 95% CI: 0.59-1.93, p = 0.83). The LOCO was significantly lower in the DEB group compared to the DES group (HR: 0.40; 95% CI: 0.16-0.98, p = 0.04), which was mainly driven by the lower levels of myocardial infarction (HR: 0.24; 95% CI: 0.06-0.94, p = 0.04) and the absence of target lesion thrombosis in the DEB group (vs. DES group 6%, p = 0.02). Additionally, cardiac death was found to be similar between the DEB and DES groups (HR: 0.56; 95% CI: 0.18-1.75, p = 0.32). DEB angioplasty showed favorable safety with a similar efficacy to that of DES implantation in DES-ISR lesions during the long-term follow-up period.
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