Drug-eluting stent vs. Balloon angioplasty in patients with in-stent restenosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Int J Cardiol
; 412: 132269, 2024 Oct 01.
Article
in En
| MEDLINE
| ID: mdl-38880417
ABSTRACT
INTRODUCTION:
In-stent restenosis (ISR) is seen in up to 20% of cases and is the primary cause of percutaneous coronary intervention (PCI) failure. With the use of re-stenting with a drug-eluting stent (DES), plain old balloon angioplasty (BA) use is decreasing. We aim to compare the efficacy and safety profile of DES over BA in the management of ISR.METHODS:
Electronic databases were searched to identify all randomized controlled trials (RCTs) comparing DES to BA for coronary ISR. The mantel-Haenszel method with a random effects model was used to calculate pooled risk ratios (RR).RESULTS:
Four trials comprising 912 patients (543 in DES and 369 in the BA group) were included in the final study. The mean follow-up was 45 months. DES was found to be superior with a lower requirement of target vessel revascularization (TVR) (RR 0.45, 95% CI 0.31-0.64, p-value <0.0001), and target lesion revascularization (TLR) (RR 0.59, 95%CI 0.44-0.78, p-value 0.0002) compared to BA. However, all-cause mortality, cardiovascular mortality, incidence of myocardial infarction (MI), and target lesion thrombosis were not different between the two intervention arms.CONCLUSION:
DES was found to be superior to BA for the management of coronary ISR with a reduction in the risk of TLR and TVR. No difference in mortality, risk of MI, or target lesion thrombosis was observed between the two interventions.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Angioplasty, Balloon, Coronary
/
Randomized Controlled Trials as Topic
/
Coronary Restenosis
/
Drug-Eluting Stents
Limits:
Humans
Language:
En
Journal:
Int J Cardiol
/
Int. j. cardiol
/
International journal of cardiology
Year:
2024
Document type:
Article
Affiliation country:
Country of publication: