Usefulness of Drug-Eluting Balloons for Bare-Metal and Drug-Eluting In-Stent Restenosis (From the RIBS IV and V Randomized Trials)

Abstract Treatment of patients with drug-eluting stent (DES) in-stent restenosis (ISR) is particularly challenging. We sought to compare results of drug-eluting balloons (DEB) in patients with DES-ISR with those in patients with bare-metal stent (BMS) ISR. A pooled analysis of the RIBS IV and RIBS V...

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Bibliographic Details
Published in:The American journal of cardiology 2017-04, Vol.119 (7), p.983-990
Main Authors: Alfonso, Fernando, MD, Pérez-Vizcayno, María José, MD, García del Blanco, Bruno, MD, García-Touchard, Arturo, MD, López-Mínguez, José-Ramón, MD, Sabaté, Manel, MD, Zueco, Javier, MD, Melgares, Rafael, MD, Hernández, Rosana, Moreno, Raul, MD, Domínguez, Antonio, MD, Sanchís, Juan, MD, Moris, Cesar, MD, Moreu, José, MD, Cequier, Angel, MD, Romaguera, Rafael, MD, Rivero, Fernando, MD, Cuesta, Javier, MD, Gonzalo, Nieves, MD, Jiménez-Quevedo, Pilar, MD, Cárdenas, Alberto, MD, Fernández, Cristina, MD
Format: Article
Language:English
Subjects:
Aged
Cardiology
Cardiovascular
Coronary Angiography
Coronary Restenosis - diagnostic imaging
Coronary Restenosis - therapy
Diabetes
Drug-Eluting Stents
Everolimus - therapeutic use
Female
Heart attacks
Humans
Intervention
Male
Medical imaging
Paclitaxel - therapeutic use
Stents
Studies
Treatment Outcome
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Summary:Abstract Treatment of patients with drug-eluting stent (DES) in-stent restenosis (ISR) is particularly challenging. We sought to compare results of drug-eluting balloons (DEB) in patients with DES-ISR with those in patients with bare-metal stent (BMS) ISR. A pooled analysis of the RIBS IV and RIBS V randomized trials was performed. Both trials had identical inclusion/exclusion criteria. Results of DEB in 95 patients with BMS-ISR and 154 patients with DES-ISR were compared. Patients with DES-ISR were more frequently diabetics, presented more often as an acute coronary syndrome and had more severe lesions and more frequently a focal pattern, including edge-ISR. Late angiographic findings (92% of eligible patients), including minimal lumen diameter (1.80±0.6 vs 2.01±0.6 mm,p=0.001) (absolute mean difference 0.21 mm; 95%CI 0.04-0.38;p=0.014) and restenosis rate (19 vs 9.5%, p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2016.12.006