scholarly journals TCT-574 Circulating Angiostatin Predicting the Risk of Repeat Target Lesion Revascularization in CAD Patients Suffered In-stent Restenosis after Coronary Intervention

2018 ◽  
Vol 72 (13) ◽  
pp. B230
Author(s):  
Zhangwei Chen
Keyword(s):  
Coronary Intervention ◽  
Target Lesion ◽  
Target Lesion Revascularization ◽  
Stent Restenosis ◽  
In Stent Restenosis

scholarly journals Long-Term Outcomes Following Drug-Eluting Balloons Versus Thin-Strut Drug-Eluting Stents for Treatment of In-Stent Restenosis (DEB-Dragon-Registry)

2021 ◽  
Author(s):  
Wojciech Wańha ◽  
Jacek Bil ◽  
Rafał Januszek ◽  
Natasza Gilis-Malinowska ◽  
Tomasz Figatowski ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Death ◽  
Coronary Intervention ◽  
Target Lesion ◽  
Target Lesion Revascularization ◽  
Target Vessel ◽  
End Point ◽  
Stent Restenosis ◽  
Drug Eluting ◽  
In Stent Restenosis

Background: Data regarding the use of percutaneous coronary intervention with drug-eluting balloons (DEB) versus thin-strut drug-eluting stents (thin-DES) for treating DES in-stent restenosis in everyday clinical practice is scarce. Our goal was to evaluate the efficacy and safety profile of DEB versus thin-DES in DES in-stent restenosis. Methods: Consecutive patients with DES in-stent restenosis who underwent percutaneous coronary intervention between 2008 and 2019 entered the multicenter DEB-DRAGON Registry with a follow-up of 3 years. Patients who received DEB at the index procedure (n=557, 49.9%) were compared with those who received thin-DES (n=560, 50.1%). Results: Analysis of the unmatched cohort revealed lower rates of target lesion revascularization (9.1% versus 13.6%; hazard ratio [HR], 0.58 [95% CI, 0.41–0.83], P =0.003), target vessel revascularization (11.8% versus 16.7%; HR, 0.62 [95% CI, 0.45–0.84], P =0.003) and device-oriented composite end point, defined as a composite of cardiac death, target lesion revascularization, and target vessel myocardial infarction (12.7% versus 16.0%; HR, 0.69 [95% CI, 0.50–0.94], P =0.018) in the thin-DES group compared with the DEB group. The incidence of cardiac death, target vessel-myocardial infarction, and myocardial infarction were similar in both groups. However, after propensity score matching, there were no significant differences in target lesion revascularization (11.2% versus 11.2%; HR, 0.91 [95% CI, 0.55–1.51], P =0.707), target vessel revascularization (13.4% versus 14.2%; HR, 0.86 [95% CI, 0.55–1.36], P =0.523), and device-oriented composite end point (14.2% versus 14.2%; HR, 0.91 [95% CI, 0.58–1.42], P =0.667) between the thin-DES and DEB group, respectively. Conclusions: This analysis of a real-life registry revealed similar long-term outcomes of thin-DES and DEB in DES in-stent restenosis regarding target lesion revascularization, myocardial infarction, cardiac death, and device-oriented composite end point. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04415216.

scholarly journals Drug-Coated Balloons versus Everolimus-Eluting Stents in Patients with In-Stent Restenosis: A Pair-Wise Meta-Analysis of Randomized Trials

2020 ◽  
Vol 2020 ◽  
pp. 1-11 ◽  
Author(s):  
Nina Peng ◽  
Wei Liu ◽  
Zongzhuang Li ◽  
Jun Wei ◽  
Xuejun Chen ◽  
...  
Keyword(s):  
Randomized Trials ◽  
Target Lesion ◽  
Target Lesion Revascularization ◽  
Lumen Diameter ◽  
Metal Stents ◽  
Stent Restenosis ◽  
Clinical Events ◽  
Minimum Lumen Diameter ◽  
Meta Analyses ◽  
In Stent Restenosis

Objective. This study aimed to compare the effectiveness of drug-coated balloons (DCB) with everolimus-eluting stents (EES) in the treatment of in-stent restenosis (ISR) and the differential relative effect of DCB in patients with drug-eluting stents (DES)-ISR and bare metal stents (BMS)-ISR. Background. The efficiency and safety of DCB and EES need to be assessed for the treatment of ISR. Methods. A systematic literature search was conducted using PubMed and EMBASE to identify all relevant studies. Angiographic results and clinical events were separately assessed. Subgroup meta-analyses were performed according to the type of restenosed stent. Results. Six randomized trials with 1134 patients were included. The overall pooled outcomes indicated that DCB was associated with lower minimum lumen diameter (mean difference MD=−0.17, 95% CI = −0.29 to −0.05, P=0.006) and higher target lesion revascularization (risk ratio RR=2.38, 95% CI = 1.36 to 4.18, P=0.002) than EES. However, the subgroup meta-analyses showed that DCB was inferior to EES only in DES-ISR patients, with lower minimum lumen diameter (MD=−0.25, 95% CI = −0.37 to −0.14, P<0.001), higher percent diameter stenosis (MD=5.37, 95% CI = 1.33 to 9.42, P=0.009), more binary restenosis (RR=2.07, 95% CI = 1.20 to 3.58, P=0.009), and higher incidence of target vessel revascularization (RR=2.07, 95% CI = 1.22 to 3.50, P=0.007) and target lesion revascularization (RR=2.43, 95% CI = 1.28 to 4.22, P=0.002). No differences in angiographic results and clinical events were found between DCB and EES in BMS-ISR patients. Conclusions. DCB was inferior to EES in DES-ISR and comparable in BMS-ISR in terms of angiographic results and clinical events.

Abstract 17459: Drug Eluting Balloon Angioplasty is a Safe Treatment Option for In-stent Restenosis: Meta-analysis of Current Evidence

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Sainath Gaddam ◽  
Bhavi Pandya ◽  
Mustafain Meghani ◽  
Vratika Agarwal ◽  
Armaghan Soomro ◽  
...  
Keyword(s):  
Balloon Angioplasty ◽  
Target Lesion ◽  
Target Lesion Revascularization ◽  
Current Evidence ◽  
Stent Restenosis ◽  
Number Of Patients ◽  
Drug Eluting ◽  
Drug Eluting Balloon ◽  
Plain Old Balloon Angioplasty ◽  
In Stent Restenosis

Introduction: Drug eluting balloons (DEB) were recently approved by FDA for peripheral artery interventions only. For coronary in-stent restenosis (ISR), the ACC/AHA/SCAI 2011 PCI guidelines have no recommendations on role for DEB. While ESC/EACTS 2010 PCI guidelines, have level IIa recommendation for DEB for ISR after a bare metal stent. The drug delivery kinetics with DEB allows shorter duration of dual anti-platelet therapy and has a potential role in ballooning side branches of a bifurcating lesion after stenting. Aim: To compare safety and efficacy of DEB angioplasty vs. plain old balloon angioplasty (BA) or drug eluting stent (DES) for treating coronary ISR. Methods and Results: A thorough search was performed on Pubmed, Embace and Google scholar databases for randomized control trials (RCT) comparing DEB vs. BA or DES for ISR. We compared target lesion revascularization (TLR) and MACE events for these groups. We also pooled data from registries and observation studies on DEB for outcome analysis. Total number of patients with DEB’s in our study was 3465, with 693 DEB’s in 8 RCT’s. Mean follow up period was 11 months. Pooled analysis showed significant benefit for DEB compared to plain old BA, for events of target lesion revascularization (OR= 0.25, p<0.0001), and death (OR=0.31, p<0.0001). Comparing DEB to DES, there was no statistical difference in outcomes comparing TLR (OR=1.4, p=0.14), MI or death (OR=0.65, p=0.39). Cumulative incidence of target lesion revascularization (TLR) with DEB was 6.7%. Conclusions: For coronary ISR, drug eluting balloon angioplasty is superior to plain old balloon angioplasty in terms of safety and outcomes. However, comparing drug eluting balloons vs. drug eluting stents in ISR, the outcomes are comparable and will need larger studies powered to make definitive recommendation.

scholarly journals 1101-45 Contribution of stent underexpansion to target lesion revascularization after sirolimus-eluting stenting for in-stent restenosis

2004 ◽  
Vol 43 (5) ◽  
pp. A66-A67
Author(s):  
Kenichi Fujii ◽  
Yoshio Kobayashi ◽  
Gary S Mintz ◽  
Hideo Takebayashi ◽  
Takenori Yasuda ◽  
...  
Keyword(s):  
Target Lesion ◽  
Target Lesion Revascularization ◽  
Stent Restenosis ◽  
In Stent Restenosis
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