Comparison of drug-eluting stents and cutting balloon in the management of in-stent restenosis

doi:10.3969/j.issn.1006-7795.2017.03.026

Abstract

Abstract: Objective To evaluate and compare the efficacy of drug-eluting stents (DES) and cutting balloon (CB) for the management of in-stent restenosis (ISR). Methods The immediate and (6.0±1.4) months follow-up angiographic outcomes of 124 patients with ISR who were treated by drug eluting stents and cutting balloon were analyzed in this retrospective study. Results Baseline characteristics and angiographic profile were similar between these two groups. There was no statistically significant difference between two groups both in acute post procedure minimum lumen diameter (2.54±0.45 vs 2.67±0.48 mm, P>0.05) and diameter stenosis (23.5% vs 21.8%, P>0.05) between DES and CB groups. At six-month follow-up study, however, the DES group showed significantly larger in the minimum lumen diameter (1.86±0.63 mm) than the CB group(1.34±0.71 mm) (P<0.01), and the diameter stenosis in the DES group was lower than that in the CB group(39.2% vs 47.8%,respectively,P<0.05).Furthermore, the recurrent restenosis rate as well as lumen loss in the DES group (4.1% and 0.52±0.48 mm, respectively) were significantly lower compared with those of CB group (9.8% and 0.74±0.53 mm, respectively with P<0.01). Conclusion Drug-eluting stents is comparable with cutting balloon in terms of immediate outcomes but superior to the latter in terms of efficacy at 6-month follow-up.

Key words: drug-eluting stents, in-stent restenosis, balloon angioplasty, percutaneous coronary

CLC Number:

R541.4

Sun Shuai, Zou Meiping, Liu Qiang, Weng Jianxin. Comparison of drug-eluting stents and cutting balloon in the management of in-stent restenosis[J]. Journal of Capital Medical University, 2017, 38(3): 465-469.

0
/ / Recommend

Add to citation manager EndNote|Reference Manager|ProCite|BibTeX|RefWorks

URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2017.03.026

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2017/V38/I3/465

References

[1] Serruys P W, Kutryk M J, Ong A T. Coronary-artery stents[J]. New Engl J Med,2006,354(5):483-95.
[2] Buccheri D, Piraino D, Andolina G, et al. Understanding and managing in-stent restenosis:A review of clinical data, from pathogenesis to treatment[J]. J Thorac Dis,2016, 8(10):E1150-E1162.
[3] Liou K, Jepson N, Cao C, et al. Drug-eluting balloon versus second generation drug eluting stents in the treatment of in-stentRestenosis:A systematic review and meta-analysis[J].Heart Lung Circ,2016,25(12):1184-1194.
[4] Marroquin O C, Selzer F, Mulukutla S R, et al. A comparison of bare-metal and drug-eluting stents for off -label indications[J].N Engl J Med,2008,358(4):342-352.
[5] 乔岩,马长生,聂绍平,等. 药物洗脱支架与金属裸支架置入术后对糖尿病病人远期死亡、心肌梗死和支架血栓发生情况的影响[J].首都医科大学学报,2012,33(4):437-445.
[6] Byrne R A, Sarafoff N, Kastrati A, et al. Drug-eluting stents in percutaneous coronary intervention:a benefit-risk assessment[J].Drug Saf,2009, 32(9):749-770.
[7] Dangas G D, Claessen B E, Caixeta A, et al. In-stent restenosis in the drug-eluting stent era[J].J Am Coll Cardiol,2010,56(23):1897-1907.
[8] Kastrati A, Byrne R. New roads, new ruts:lessons from drug-eluting stent restenosis[J].JACC Cardiovasc Interv,2011, 4(2):165-167.
[9] Lee J M, Rhee T M, Hahn JY, et al. Comparison of outcomes after treatment of in-stent restenosis using newer generation drug-eluting stents versus drug-eluting balloon:Patient-level pooled analysis of korean multicenter in-stent restenosis registry[J].Int J Cardiol, 2017,230:181-190.
[10] Pourier V E, de Borst G J. Technical options for treatment of in-stent restenosis after carotid artery stenting[J].J Vasc Surg, 2016,64(5):1486-1496.
[11] Albiero R, Silber S, Mario C D, et al. Cutting balloon versus conventional balloon angioplasty for the treatment of in-stent restenosis:results of the restenosis cutting balloon evaluation trial(RESCUT)[J].J Am Coll Cardiol,2004,43(6):943.
[12] Mehilli J, Byrne R A, Tiroch K, et al. Randomized trial of paclitaxel-versus sirolimus-eluting stents for treatment of coronary restenosis in sirolimus-eluting stents:the ISAR-DESIRE 2(Intracoronary stenting and angiographic results:drug eluting stents for in-stent restenosis2)study[J].J Am Coll Cardiol,2010,55(24):2710-2716.
[13] Kokkinidis D G, Waldo S W, Armstrong E J. Treatment of coronary artery in-stent restenosis[J].Expert Rev Cardiovasc Ther,2017,15(3):191-202.
[14] Alfonso F, Pérez-Vizcayno M J, García Del Blanco B, et al.Usefulness of drug-eluting balloons for bare-metal and drug-eluting in-stent restenosis (from the RIBS IV and V Randomized Trials)[J]. Am J Cardiol, 2017, 119(7):983-990
[15] Wang JY, Haider SA, Silva R, et al.Stent grafts for treatment of in stent restenosis and stent occlusions in an office based lab[J]. Ann Vasc Surg, 2017, 38:4-5.
[16] Habara S, Iwabuchi M,Inoue N, et al. A multicenter randomized comparison of paclitaxel-coated balloon catheter with conventional balloon angioplasty in patients with bare-metal stent restensis and drug-eluting stent restenosis[J]. Am Heart J, 2013,166(3):527-533.
[17] Koniari I, Kounis N G, Hahalis G. In-stent restenosis and thrombosis due to metal hypersensitivity:implications for Kounis syndrome[J].J Thorac Dis,2016, 8(11):3056-3058.
[18] 黄辉, 袁彬,冯凯,等.血清TB与Fib对冠心病患者药物洗脱支架置入术后再狭窄影响的研究[J].中国煤炭工业医学杂志,2015,18(8):1299-1303.
[19] 葛均波. 开拓新兴介入技术发展多元介入治疗[J].中国介入心脏病学杂志, 2013, 21(1):1.
[20] 祝宝华,Josef N, Gerhard S. 准分子激光与旋磨术在冠状动脉支架再狭窄治疗中的作用[J].实用临床医药杂志,2007,1 (11):31-34.
[21] 卢长林,郭炜华,杨跃进,等.冠状动脉支架内再狭窄的现状与展望[J].中国心血管杂志, 2012,17 (6):409-412.
[22] Chevalier B, Moulichon R, Terger E, et al. One-year results of the CRISTAL Trial, a randomized comparison of cipher sirolimus-dluting coronary stents versus balloon angioplasty for restenosis of drug-eluting stents[J]. J Interv Cardiol,2012, 25(6):586-595.
[23] Byrne R A, Neumann F J. Mehilli J, et al. Paclitaxel-eluting balloons, paclitaxel-eluting stents, and balloon angioplasty in patients with restenosis after implantation of a drug-eluting stent (ISAR-DESIRE 3); a randomised, open-label trial[J]. Lancet, 2013, 381(9865):461-467.
[24] Xu B, Gao R, Wang J, et al. A prospective, multienter, randomized trial of Paclitaxel-coated balloon versus paclitaxel-eluting stent for the treatment of drug-eluting stet in-stent restenosis; results from the PEPCAD China ISR trial[J]. JACC Cardiovase Inerv, 2014, 7(2):204-211.
[25] Kolh P, Windecker S, Alfonso F, et al. 2014 ESC/EACTS Guidelines on myocardial revascularization:The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI)[J].Eur Heart J, 2014, 35(37):2541 -2619.