Long-term outcomes following drug-eluting balloons vs. thin-strut drug-eluting stents for treatment of recurrent restenosis in drug-eluting stents
Year: 2022
Type: article
Study design: Observational Study
Abstract: BACKGROUND: There is limited data on the optimal revascularization strategy in patients with recurrent in-stent restenosis (R-ISR). AIMS: To compare the long-term outcomes of patients treated with either a thin-strut drug-eluting stent (thin-DES) or a drug-eluting balloon (DEB) for R-ISR in a drug-eluting stent (DES). METHODS: A multicenter DEB-DRAGON registry was used to retrospectively identify patients with R-ISR who received either a thin-DES or a DEB. Propensity score matching was applied to adjust for baseline differences. The primary outcome was target lesion revascularization (TLR). RESULTS: Out of 311 patients (mean age, 67 years; 63% male) with R-ISR, 86 (27.7%) were treated with a thin-DES and 225 (72.3%) with a DEB. Median follow-up was 2.6 years. TLR occurred in 18 (20.9%) patients who received thin-DES and 61 (27.1%) patients treated with DEB (hazard ratio [HR], 0.57; 95% confidence interval [CI], 0.33-0.98; log-rank P = 0.04). The difference remained significant in a propensity score-matched cohort of 57 patients treated with thin-DES and 57 patients treated with a DEB (17.5 vs. 33.3%, respectively; HR, 0.38; 95% CI, 0.17-0.86; P = 0.01). The risks of device-oriented adverse cardiac events and all-cause mortality were similar after thin-DES or DEB in both unadjusted and propensity score-matched cohorts. In a multivariable Cox proportional hazard model, the treatment with a thin-DES was an independent predictor of a TLR-free survival (HR, 0.33; 95% CI 0.13-0.84; P = 0.02). CONCLUSIONS: In patients with R-ISR implantation of a thin-DES is associated with a lower risk of repeated revascularization compared with angioplasty with a DEB.
Source: Kardiologia Polska
Authors: Rafał Wolny, Ilona Kowalik, Rafał Januszek, Jacek Bil, Tomasz Figatowski, Marek Milewski, Brunon Tomasiewicz, Tomasz Walczak, Bruno Hrymniak, Piotr Desperak, Piotr Niezgoda, Magdalena Chudzik, Łukasz Kuźma, Paweł Kralisz, Fabrizio D'Ascenzo, Damian Hudziak, Miłosz Jaguszewski, Krzysztof Reczuch, Jacek Kubica, Robert J Gil, Sławomir Dobrzycki, Stanisław Bartuś, Mariusz Gąsior, Andrzej Ochała, Adam Witkowski, Wojciech Wojakowski, Wojciech Wańha
Institutions: Institute of Cardiology, Jagiellonian University, Ministry of Interior and Administration, Central Clinical Hospital, Gdańsk Medical University, Medical University of Silesia, Wroclaw Medical University, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Medical University of Warsaw, Medical University of Białystok, University of Turin
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4224256656