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Review
. 2018 Jul 24:2018:7658145.
doi: 10.1155/2018/7658145. eCollection 2018.

Drug-Eluting Balloons versus Second-Generation Drug-Eluting Stents for Treating In-Stent Restenosis in Coronary Heart Disease after PCI: A Meta-Analysis

Wen-Juan Xiu  1 , Hai-Tao Yang  1 , Ying-Ying Zheng  1 , Yi-Tong Ma  1 , Xiang Xie  1
Affiliations
Review

Drug-Eluting Balloons versus Second-Generation Drug-Eluting Stents for Treating In-Stent Restenosis in Coronary Heart Disease after PCI: A Meta-Analysis

Wen-Juan Xiu et al. Cardiol Res Pract. .

Abstract

Background: In-stent restenosis (ISR) remains a common problem following percutaneous coronary intervention (PCI). However, the best treatment strategy remains uncertain. There is some controversy over the efficacy of drug-eluting balloons (DEBs) and second-generation drug-eluting stents (DESs) for treating ISR.

Methods: A meta-analysis was used to compare the efficacy of the DEB and second-generation DES in the treatment of ISR. The primary endpoint is the incidence of target lesion revascularization (TLR). The secondary endpoint is the occurrence of target vessel revascularization (TVR), myocardial infarction (MI), all-cause death (ACM), cardiac death (CD), major adverse cardiac events (MACEs), minimum luminal diameter (MLD), late luminal loss (LLL), binary restenosis (BR), and percent diameter stenosis (DS%).

Results: A total of 12 studies (4 randomized controlled trials and 8 observational studies) including 2020 patients with a follow-up of 6-25 months were included in the present study. There was a significant difference in the MLD between the two groups during follow-up (P=0.007, RR = 0.23, and 95% CI: 0.06-0.4 mm). There was no significant difference in LLL, BR, or DS% and the overall incidence of MACEs between the two groups. Subgroup analysis showed no significant difference in the incidence of primary and secondary endpoints when considering RCTs or observational studies only.

Conclusions: The efficacy of the DEB and second-generation DES in the treatment of ISR is comparable. However, our results need further verification through multicenter randomized controlled trials.

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Figures

Figure 1
Figure 1
Flow diagram of the literature search and study selection.
Figure 2
Figure 2
Document quality evaluation.
Figure 3
Figure 3
Clinical outcomes between the DEB group and DES group: (a) TLR; (b) TVR; (c) MI; (d) ACM.
Figure 4
Figure 4
Cardiac death (a) and MACEs (b) between the DEB group and DES group.
Figure 5
Figure 5
Coronary angiography outcomes between the DEB group and DES group: (a) MLD; (b) late loss; (c) binary restenosis; (d) DS%.
See this image and copyright information in PMC

References

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