Clinical Outcomes of Drug Eluting Balloon (DEB) in Treatment of Coronary In-Stent Restenosis (ISR) Compared to Plain Old Balloon Angioplasty (POBA) and Drug Eluting Stent (DES).

초록

Background Treatment of coronary in-stent restenosis (ISR) is still high incidence of recurrence of ISR. We aimed to compare the efficacy and safety of a paclitaxel drug eluting balloon (DEB) in treatment of ISR to POBA and DES. Methods We reviewed 179 patients (190 lesions, male 70.4%, mean age 64.1±11.7 years) who treated ISR with DEB or POBA or DES from January 2006 to May 2012. The primary end point was major adverse cardiac events (cardiac death, myocardial infarction, target lesion revascularization). Results We reviewed 179 patients, 190 ISR lesions (LAD/LCX/RCA/LM; 46.8/16.8/33.7/2.2%, ISR type Ia/Ib/Ic/Id/II/III/IV; 0.5/24.2/23.2/22.1/6.3/10.5%). Sixty seven patients treated with POBA and 54 patients with DES. And 58 patients were treated with the DEB (mean diameter/length/pressure/time; 3.0±0.3mm/ 21.7±4.4mm/ 10.4±2.4atm/ 45.6±23.6sec). Mean clinical follow up was 16.3±11.2 months. During the follow up, overall, total major adverse cardiac events were 20 (11.2%). There were 6 cardiac deaths (3.3%), one myocardial infaction (0.6%), and 13 target lesion revascularization (7.3%) and 3 stent thrombosis (1.7%). But there was no difference between 3 groups (Table). Conclusion Treatment of coronary in-stent restenosis with DEB showed feasible and relatively low MACE compared to POBA and DES in small and short-term of this study. But large and long term clinical and angiographic follow up will be needed.