Efficacy of Drug-Eluting Balloons for Patients With In-Stent Restenosis: A Meta-Analysis of 8 Randomized Controlled Trials.
The optimal treatment for in-stent restenosis (ISR) of both bare-metal stent (BMS) and drug-eluting stent (DES) is currently unclear. The aim of this meta-analysis was to assess the role of drug-eluting balloon (DEB) as an optional treatment for ISR. We searched PubMed, MEDLINE, EMBASE, BIOS, and Web of Science from 2005 to July 2014. Eight studies, enrolling 1413 patients were included. Main end points were late lumen loss (LLL), binary in-segment restenosis (BR), major adverse cardiac events (MACEs), target lesion revascularization (TLR), death, myocardial infarction (MI), and stent thrombosis (ST). When compared to plain old balloon angioplasty (POBA), DEB treatment significantly reduced the risk of MACE (risk rato [RR] 0.37, P < .01), death (RR 0.44, P = .04), TLR (RR 0.27, P < .01), BR (RR [95% CI]: 0.23[0.12 to 0.43], P < .01) and associated with better outcomes of LLL ( 0.50 [ 0.65 to 0.35] mm, P < .01). However, the differences were not significant between DEB treatment and DES treatment in all primary and secondary end points. The DEB was a better option to treat ISR when compared to POBA. However, it had similar effects as DES.
Department of Epidemiology, Capital Medical University, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Disease, China.
Shen
S
Gao
Hematology Department, Capital Medical University, Friendship Hospital, China.
Jing
J
Shen
Department of Internal Medicine, Baton Rouge General Medical Center, Baton Rouge, LA, USA.
Venkata Kishore
VK
Mukku
Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA.
Mei Jia
MJ
Wang
Cardiology Department, Capital Medical University, Beijing Anzhen Hospital, China.
Muzina
M
Akhtar
Cardiology Department, Capital Medical University, Beijing Anzhen Hospital, China Liuwei525@hotmail.com.
Wei
W
Liu
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D062906:Cardiac Catheters; D016009:Chi-Square Distribution; D020099:Coated Materials, Biocompatible; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D011474:Prosthesis Design; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome
D020099:Coated Materials, Biocompatible
balloon angioplasty; coronary artery disease; drug-eluting balloon; drug-eluting stent; in-stent restenosis