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Updated: May 6, 2026

Imaging In-Stent Restenosis: An Inexpensive, Reliable, and Rapid Preclinical Model
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Imaging In-Stent Restenosis: An Inexpensive, Reliable, and Rapid Preclinical Model

Published on: September 14, 2009

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Drug-coated balloons versus drug-eluting stents in patients with in-stent restenosis: An updated meta-analysis with

Ahmed Abdelaziz1,2, Karim Atta3,4, Abdelrahman H Hafez3,5

  • 1Medical Research group of Egypt (MRGE), Cairo, Egypt. ahmedmhmd0144@gmail.com.

Journal of Cardiothoracic Surgery
|November 7, 2024
PubMed

Insights

Drug-coated balloons (DCB) show comparable clinical outcomes to drug-eluting stents (DES) for in-stent restenosis (ISR). However, DCBs were associated with a higher rate of target lesion revascularization (TLR).

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Biomaterials Science

Background:

  • In-stent restenosis (ISR) management remains a challenge.
  • Drug-coated balloons (DCB) show promise for ISR, but their clinical role is not well-established.
  • Evaluating DCB efficacy and safety in ISR is crucial for contemporary practice.

Purpose of the Study:

  • To comprehensively appraise the efficacy and safety of DCBs versus DES in ISR patients.
  • To compare primary endpoints of major adverse cardiac events (MACE) and late lumen loss (LLL).
  • To assess secondary clinical and angiographic outcomes, including target lesion revascularization (TLR).

Main Methods:

  • Systematic search of major databases (PubMed, Scopus, Web of Science, Ovid, Cochrane Central) until March 2023.
  • Inclusion of randomized controlled trials (RCTs) comparing DCB versus DES in ISR.
  • Primary endpoints: MACE and LLL; Secondary endpoints: TLR, death, MI, TVR, stent thrombosis, MLD, binary restenosis.

Main Results:

  • Ten RCTs with 1977 patients were analyzed.
  • No significant difference in MACE between DCB and DES (OR 1.04, 95% CI: 0.87-1.44).
  • Comparable LLL (MD -0.08, 95% CI: -0.18-0.02), but increased TLR with DCB (OR 1.54, 95% CI: 1.2-1.99).

Conclusions:

  • DCB is comparable to DES for ISR clinical outcomes, but with higher TLR rates.
  • Further large-scale RCTs with longer follow-up are needed to validate these findings.
  • DCB's role in ISR requires careful consideration due to increased TLR risk.
Abstract

Keywords:
DCBDESIn-stent restenosisMeta-analysisPCI

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