title: Cutting balloon versus conventional balloon angioplasty for the treatment of in-stent restenosis: results of the restenosis cutting balloon evaluation trial (RESCUT).
abstract: OBJECTIVE
  The aim of this trial was to compare cutting balloon angioplasty (CBA) with conventional balloon angioplasty (i.e., percutaneous transluminal coronary angioplasty [PTCA]) for the treatment of patients with coronary in-stent restenosis (ISR).
  
  
  BACKGROUND
  Retrospective studies suggest CBA might be superior to conventional PTCA in the treatment of ISR.
  
  
  METHODS
  The Restenosis Cutting Balloon Evaluation Trial (RESCUT) is a multicenter, randomized, prospective European trial including 428 patients with all types of ISR (e.g., focal, multifocal, diffuse, proliferative).
  
  
  RESULTS
  In both groups, the majority of ISR lesions were shorter than 20 mm. The length of restenotic stents was similar (CBA: 18.6 +/- 9.7 mm; PTCA: 18.3 +/- 8.7 mm). The number of balloons used to treat ISR was lower in the CBA group: only one balloon was used in 82.3% of CBA cases, compared with 75% of PTCA procedures (p = 0.03). Balloon slippage was less frequent in the CBA group (CBA 6.5%, PTCA 25%; p < 0.01). There was a trend toward a lower need for additional stenting in the CBA group (CBA 3.9%, PTCA 8.0%; p = 0.07). At seven-month angiographic follow-up, the binary restenosis rate was not different between the groups (CBA 29.8%, PTCA 31.4%; p = 0.82), with a similar pattern of recurrent restenosis. Clinical events at seven months were also similar.
  
  
  CONCLUSIONS
  Cutting balloon angioplasty did not reduce recurrent ISR and major adverse cardiac events, as compared with conventional PTCA. However, CBA was associated with some procedural advantages, such as use of fewer balloons, less requirement for additional stenting, and a lower incidence of balloon slippage.
authors.affiliation: Columbus Hospital, Milan, Italy. remo.albiero@email.it
authors.forename: Remo
authors.initials: R
authors.lastname: Albiero
authors.forename: Sigmund
authors.initials: S
authors.lastname: Silber
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Mario
authors.forename: Carmelo
authors.initials: C
authors.lastname: Cernigliaro
authors.forename: Salvatore
authors.initials: S
authors.lastname: Battaglia
authors.forename: Bernhard
authors.initials: B
authors.lastname: Reimers
authors.forename: Arian
authors.initials: A
authors.lastname: Frasheri
authors.forename: Volker
authors.initials: V
authors.lastname: Klauss
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Auge
authors.forename: Paolo
authors.initials: P
authors.lastname: Rubartelli
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Morice
authors.forename: Alberto
authors.initials: A
authors.lastname: Cremonesi
authors.forename: Joachim
authors.initials: J
authors.lastname: Schofer
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bortone
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
mesh_terms: D000800:Angioplasty, Balloon / Q000379:methods*; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015607:Stents; D016896:Treatment Outcome