title: The efficacy and safety of drug-eluting balloons for the treatment of in-stent restenosis as compared with drug-eluting stents and with conventional balloon angioplasty.
abstract: OBJECTIVE
  Treatment of coronary in-stent restenosis (ISR) is still associated with a high incidence of recurrence. We aimed to compare the efficacy and safety of drug-eluting balloons (DEB) for the treatment of ISR as compared with conventional balloon angioplasty (BA) and drug-eluting stents (DES).
  
  
  METHODS
  Between January 2006 and May 2012 a total of 177 patients (188 lesions, 64.1 ± 11.7 years old) who underwent percutaneous coronary intervention for ISR were retrospectively enrolled. Clinical outcomes were compared between patients treated with DEB (n = 58, 32.8%), conventional BA (n = 65, 36.7%), or DES (n = 54, 30.5%). The primary end point was a major adverse cardiac event (MACE), defined as a composite of cardiac death, myocardial infarction, and target lesion revascularization(TLR).
  
  
  RESULTS
  Baseline characteristics were not different except for a history of previous MI, which was more frequent in patients treated by conventional BA or DES than in patients treated by DEB (40.0% vs. 48.1% vs. 17.2%, respectively, p = 0.002). The total incidences of MACEs were 10.7%, 7.4%, and 15.4% in patients treated by DEB, DES, or conventional BA, respectively (p > 0.05). TLR was more frequent in patients treated by conventional BA than in patients treated by DEB or DES, but this was not statistically significant (10.8% vs. 6.9% vs. 3.7%, p > 0.05 between all group pairs, respectively).
  
  
  CONCLUSIONS
  This study showed that percutaneous coronary intervention using DEB might be a feasible alternative to conventional BA or DES implantation for treatment of coronary ISR. Further large-scaled, randomized study assessing long-term clinical and angiographic outcomes will be needed.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Pyung Chun
authors.initials: PC
authors.lastname: Oh
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Soon Yong
authors.initials: SY
authors.lastname: Suh
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Woong Chol
authors.initials: WC
authors.lastname: Kang
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Kyounghoon
authors.initials: K
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Han
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Taehoon
authors.initials: T
authors.lastname: Ahn
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Eak Kyun
authors.initials: EK
authors.lastname: Shin
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D062906:Cardiac Catheters; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D002423:Cause of Death; 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*; D054855:Drug-Eluting Stents; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D011474:Prosthesis Design; D019233:Retreatment; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D020099:Coated Materials, Biocompatible
keywords: Coronary restenosis; Drug eluting stent