title: Comparison of Clinical Results Following the Use of Drug-Eluting Balloons for a Bare-Metal Stent and Drug-Eluting Stent Instent Restenosis.
abstract: BACKGROUND
  Drug-eluting balloons (DEBs) have emerged as a potential alternative to current treatments of instent restenosis (ISR). The study aims to investigate the clinical outcomes of a DEB angioplasty to treat bare-metal stent (BMS) ISR and drug-eluting stent (DES) ISR at 1-year clinical follow-up period.
  
  
  METHODS
  Between November 2011 and December 2014, 312 patients were diagnosed with coronary artery ISR at our hospital. A total of 426 coronary ISR lesions were treated with DEBs. The clinical outcomes, including target lesion revascularization (TLR), myocardial infarction, stroke, cardiovascular mortality, and all-cause mortality were compared between the BMS-ISR group and DES-ISR group. Propensity score matched analysis was used to minimize bias.
  
  
  RESULTS
  The average age of the patients was 64.99 ± 10.35 years, and 76.9% of the patients were male. After multivariate Cox regression analyses about 1-year recurrent restenosis in DES-ISR group, only end stage renal disease (ESRD) (P = 0.047) and previous DEB failure (P < 0.001) were identified with significant difference. After propensity score matched analysis, the bias of baseline characteristics showed no significant difference. The DES-ISR group experienced more myocardial infarctions (2.8% vs 8.3%, P = 0.075), more TLR (8.1% vs 15.4%, P = 0.051), especially at nonostial lesion (5.7% vs 14.9%, P = 0.030) than the BMS-ISR group. Higher incidence of major cardiac cerebral adverse events happened in the DES-ISR group. (11.7% vs 22.1 %, P = 0.038) CONCLUSION: During the 1-year follow-up period, DEBs angioplasty for BMS-ISR had better clinical outcomes and less TLR than DES-ISR. ESRD and previous DEB failure were associated to TLR in DES-ISR group.
authors: Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China.
authors: Wei-Chieh
authors: WC
authors: Lee
authors: Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China.
authors: Yen-Nan
authors: YN
authors: Fang
authors: Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China. ast42aiu@hotmail.com.
authors: Chih-Yuan
authors: CY
authors: Fang
authors: Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China.
authors: Chien-Jen
authors: CJ
authors: Chen
authors: Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China.
authors: Cheng-Hsu
authors: CH
authors: Yang
authors: Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China.
authors: Hon-Kan
authors: HK
authors: Yip
authors: Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China.
authors: Chi-Ling
authors: CL
authors: Hang
authors: Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China.
authors: Chiung-Jen
authors: CJ
authors: Wu
authors: Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China.
authors: Hsiu-Yu
authors: HY
authors: Fang
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D002681:China / Q000453:epidemiology; D003327:Coronary Disease / Q000401:mortality / Q000628:therapy; D023903:Coronary Restenosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D011379:Prognosis; D057216:Propensity Score; D012044:Regression Analysis; D012189:Retrospective Studies; D016896:Treatment Outcome