In:
Cardiovascular Therapeutics, Hindawi Limited, Vol. 2020 ( 2020-01-21), p. 1-11
Abstract:
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 M D = − 0.17 , 95% CI = −0.29 to −0.05, P = 0.006 ) and higher target lesion revascularization (risk ratio R R = 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 ( M D = − 0.25 , 95% CI = −0.37 to −0.14, P 〈 0.001 ), higher percent diameter stenosis ( M D = 5.37 , 95% CI = 1.33 to 9.42, P = 0.009 ), more binary restenosis ( R R = 2.07 , 95% CI = 1.20 to 3.58, P = 0.009 ), and higher incidence of target vessel revascularization ( R R = 2.07 , 95% CI = 1.22 to 3.50, P = 0.007 ) and target lesion revascularization ( R R = 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.
Type of Medium:
Online Resource
ISSN:
1755-5914
,
1755-5922
DOI:
10.1155/2020/1042329
Language:
English
Publisher:
Hindawi Limited
Publication Date:
2020
detail.hit.zdb_id:
2417088-4
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