scholarly journals Clinical Outcomes of Drug-Eluting versus Bare-Metal In-Stent Restenosis after the Treatment of Drug-Eluting Stent or Drug-Eluting Balloon: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Yi-Xing Yang ◽  
Yin Liu ◽  
Chang-Ping Li ◽  
Peng-Ju Lu ◽  
Jiao Wang ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Bare Metal ◽  
Stent Restenosis ◽  
Positive Prevention ◽  
Drug Eluting ◽  
Drug Eluting Balloon ◽  
In Stent Restenosis

Background. Although drug-eluting stents (DES) have reduced the rates of in-stent restenosis (ISR) compared with bare-metal stents (BMS), DES related ISR (DES-ISR) still occurs and outcomes of DES-ISR remain unclear. The objective of this meta-analysis was to investigate the long-term clinical outcomes of patients with DES-ISR compared with patients with BMS related ISR (BMS-ISR) after the treatment of DES or drug-eluting balloon (DEB). Methods and results. We searched the literature in the main electronic databases including PUBMED, EMBASE, Cochrane Library, and Web of Science. The primary endpoints were target lesion revascularization (TLR) and target vessel revascularization (TVR). The secondary endpoints included all cause death (ACD), cardiac death (CD), myocardial infarction (MI), stent thrombosis or re-in-stent restenosis (ST/RE-ISR), and major adverse cardiovascular events (MACEs). A total of 19 studies with 6256 participants were finally included in this meta-analysis. Results showed that the rates of TLR (P<0.00001), TVR (P<0.00001), CD (P=0.02), ST/RE-ISR (P<0.00001), and MACEs (P<0.00001) were significantly higher in the DES-ISR group than in the BMS-ISR group. No significant differences were found between the two groups in the rates of MI (P=0.05) and ACD (P=0.21). Conclusions. Our study demonstrated that patients with DES-ISR had worse clinical outcomes at the long-term follow-up than patients with BMS-ISR after the treatment of DES or DEB, suggesting that DES and DEB may be more effective for BMS-ISR than that for DES-ISR. Positive prevention of DES-ISR is indispensable and further studies concentrating on detecting the predictors of outcomes of DES-ISR are required.

Abstract 340: Drug-Eluting Balloon Versus Everolimus-Eluting Stent for Restenosis in a Bare-Metal Stent: A Meta-Analysis of Randomized Trials

2017 ◽  
Vol 37 (suppl_1) ◽  
Author(s):  
Akintunde M Akinjero ◽  
Oluwole Adegbala ◽  
Tomi Akinyemiju
Keyword(s):  
Publication Bias ◽  
Meta Analysis ◽  
Bare Metal Stents ◽  
Metal Stents ◽  
Bare Metal ◽  
Binary Restenosis ◽  
Stent Restenosis ◽  
Drug Eluting ◽  
Drug Eluting Balloon ◽  
In Stent Restenosis

Background: In-stent restenosis accounts for major morbidity and mortality among patients treated with Bare-Metal Stents (BMS). Early efforts to treat BMS in-stent restenosis with plain balloon angioplasty and first generation drug eluting stents (DES) have been ineffective, leaving drug-eluting balloon (DEB) and second generation DES, such as everolimus eluting stents (EES), as the only remaining options. For BMS in-stent restenosis, studies performed so far have yielded conflicting results, while prior meta-analyses have been influenced by inclusion of observational studies. This is the first meta-analysis to compare EES versus DEB using results from only randomized controlled trials (RCTs). Methods: A systematic search of PUBMED and EMBASE databases was conducted from first available date to August, 2016 for RCTs comparing DEB with EES. Two reviewers evaluated studies for eligibility and extracted data with binary restenosis rate as the main endpoint. We identified 901 unique citations. Odds ratios were pooled using random-effects modeling. Funnel plots were used to assess publication bias. Heterogeneity was assessed using I 2 statistic. All analysis were performed using Review Manager (RevMan) version 5.3 (Cochrane Collaboration, 2014). Results: Three RCTs met study eligibility criteria, with 684 patients and a mean follow-up of 9.5 months. There were 184 and 185 patients in the EES and DEB arms respectively. In pooled analyses, EES was not superior to DEB in binary restenosis rates (pooled odds ratio: 0.76; 95% confidence interval: 0.25-2.32; P=0.14). Heterogeneity was minimal (I 2 = 49%), and the funnel plot did not suggest publication bias. Conclusion: In patients with BMS in-stent restenosis, there were no significant differences in binary restenosis rates between EES and DEB. Our results can enhance physician decision-making regarding choice of revascularization tool in this patient population.

scholarly journals Long term clinical outcomes of brachytherapy, bare-metal stenting, and drug-eluting stenting for de novo and in-stent restenosis lesions: Five year follow-up

2011 ◽  
Vol 18 (6) ◽  
pp. 654-661 ◽  
Author(s):  
Orhan Dogdu ◽  
Mikail Yarlioglues ◽  
Mehmet G. Kaya ◽  
Erol Tulumen ◽  
Bahadir Sarli ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
De Novo ◽  
Bare Metal ◽  
Stent Restenosis ◽  
Drug Eluting ◽  
In Stent Restenosis

Vascular brachytherapy versus drug-eluting stents in the treatment of in-stent restenosis: A meta-analysis of long-term outcomes

2015 ◽  
Vol 87 (2) ◽  
pp. 200-208 ◽  
Author(s):  
Alexandre Benjo ◽  
Rhanderson N. Cardoso ◽  
Tyrone Collins ◽  
Daniel Garcia ◽  
Francisco Y. Macedo ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Drug Eluting Stents ◽  
Long Term Outcomes ◽  
Stent Restenosis ◽  
Vascular Brachytherapy ◽  
Drug Eluting ◽  
In Stent Restenosis

Long Term Clinical Outcomes of Treatment of In-Stent Restenosis With Drug Eluting Stents

2009 ◽  
Vol 18 ◽  
pp. S5
Author(s):  
S Cherian ◽  
C Sebastian ◽  
A Puri ◽  
M Liang ◽  
G Devlin
Keyword(s):  
Clinical Outcomes ◽  
Drug Eluting Stents ◽  
Stent Restenosis ◽  
Drug Eluting ◽  
In Stent Restenosis

Treatment of In-stent Restenosis – Past, Present and Future

2009 ◽  
Vol 5 (2) ◽  
pp. 74 ◽  
Author(s):  
Fernando Alfonso ◽  
Keyword(s):  
Clinical Problem ◽  
Historical Background ◽  
Drug Eluting Stents ◽  
Bare Metal ◽  
Future Perspectives ◽  
Technical Challenge ◽  
Stent Restenosis ◽  
Drug Eluting ◽  
In Stent Restenosis

In-stent restenosis (ISR) remains a significant clinical problem. The penetration of drug-eluting stents (DES) is quite variable and patients with DES may also suffer from ISR. Treatment of ISR remains a technical challenge and the long-term clinical outcome of these patients may be complicated by recurrences. Different strategies have been used for the treatment of patients with bare-metal ISR. Currently, DES constitute the intervention of choice in this setting. However, the best intervention for patients suffering from ISR after DES implantation remains to be elucidated. This report summarises our clinical and research efforts in this adverse anatomical scenario over the last decade. We will address the treatment of patients with ISR, revisiting the historical background, emphasising the currently available alternatives and disclosing future perspectives.

scholarly journals Long-Term Results of Everolimus-Eluting Stents Versus Drug-Eluting Balloons in Patients With Bare-Metal In-Stent Restenosis

2016 ◽  
Vol 9 (12) ◽  
pp. 1246-1255 ◽  
Author(s):  
Fernando Alfonso ◽  
María José Pérez-Vizcayno ◽  
Bruno García del Blanco ◽  
Imanol Otaegui ◽  
Mónica Masotti ◽  
...  
Keyword(s):  
Long Term Results ◽  
Bare Metal ◽  
Stent Restenosis ◽  
Drug Eluting ◽  
In Stent Restenosis

Long-Term Clinical Follow-Up after Drug-Eluting Stent Implantation for Bare Metal In-Stent Restenosis

2013 ◽  
Vol 26 (3) ◽  
pp. 271-277
Author(s):  
BALAZS BERTA ◽  
ZOLTAN RUZSA ◽  
GYORGY BARCZI ◽  
DAVID BECKER ◽  
LASZLO GELLER ◽  
...  
Keyword(s):  
Stent Implantation ◽  
Drug Eluting Stent ◽  
Bare Metal ◽  
Stent Restenosis ◽  
Drug Eluting ◽  
In Stent Restenosis
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