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- Title
Drug Coated Balloon Is Less Effective for Treatment of DES In-Stent Restenosis Both in Native Coronary Arteries and Saphenous Vein Grafts: Results From a Bicenter Registry.
- Authors
Resch, Markus; Ostheim, Patrick; Endemann, Dierk H.; Debl, Kurt; Buchner, Stefan; Birner, Christoph; Maier, Lars S.; Kerber, Sebastian; Luchner, Andreas; Griese, Daniel P.
- Abstract
<bold>Background: </bold>The paclitaxel drug coated balloon (DCB) is an established treatment for bare metal stent (BMS) in-stent restenosis (ISR) in native coronary arteries. The evidence of DCB-application for drug eluting stent (DES) ISR both in native coronaries and saphenous vein grafts (SVG) is limited. Aim of our study was to compare the differential efficacy of DCB for treatment of BMS- and DES-ISR in native coronary vessels and SVGs.<bold>Methods and Results: </bold>N = 135 DCB-treated patients with available follow up (FU) angiography were included in this retrospective study. Patients received treatment between April 2009 and March 2013 at 2 tertiary care hospitals in Germany. DCB was applied in BMS-ISR (n = 65; 48%) and DES-ISR (n = 70; 52%). DCB-treated lesions were located in native coronary arteries (n = 110; 81%; BMS-ISR: n = 58; 53%; DES-ISR: n = 52; 47%) and SVGs (n = 25; 19%; BMS-ISR: n = 7, 28%; DES-ISR: n = 18, 72%). Median FU was 12 months. Endpoints were binary restenosis and target lesion revascularization (TLR). Binary restenosis (29% vs. 57%; P < 0.01) and TLR (18% vs. 46%; P < 0.01) were significantly more frequent in DES-ISR versus BMS-ISR. In SVGs, TLR was required in 72% (DES-ISR) versus 14% (BMS-ISR); P = 0.02. In the Kaplan-Meier-analysis freedom from both endpoints was significantly decreased in the DES-lesions both in the total population (binary restenosis P < 0.01; TLR P < 0.01) and native coronaries (binary restenosis P = 0.02; TLR P = 0.04).<bold>Conclusions: </bold>DCB treatment is less effective in DES-ISR than in BMS-ISR. The diminished efficacy of DCB treatment is even more pronounced in DES-ISR located within degenerated SVGs.
- Subjects
GERMANY; DRUG-eluting stents; CORONARY arteries; CORONARY restenosis; REVASCULARIZATION (Surgery); KAPLAN-Meier estimator; THERAPEUTICS; ANTINEOPLASTIC agents; PACLITAXEL; CORONARY restenosis prevention; COMPARATIVE studies; RESEARCH methodology; EVALUATION of medical care; MEDICAL cooperation; PROSTHETICS; MYOCARDIAL revascularization; RESEARCH; TIME; SAPHENOUS vein; TRANSLUMINAL angioplasty; EVALUATION research; ACQUISITION of data; RETROSPECTIVE studies; CORONARY angiography; EQUIPMENT &; supplies; DIAGNOSIS; TRANSPLANTATION of organs, tissues, etc.
- Publication
Journal of Interventional Cardiology, 2016, Vol 29, Issue 5, p461
- ISSN
0896-4327
- Publication type
journal article
- DOI
10.1111/joic.12324