Abstract
BackgroundGood results of drug-eluting balloon (DEB) use are achieved in in-stent restenosis (ISR) lesions, small vessel disease, long lesions, and bifurcations. However, few reports exist about DEB use in acute myocardial infarction (AMI) with ISR. This study’s aim was to evaluate the efficacy of DEB for AMI with ISR.MethodsBetween November 2011 and December 2015, 117 consecutive patients experienced AMI including ST-segment elevation MI, and non-ST-segment elevation MI due to ISR, and received percutaneous coronary intervention (PCI). We divided our patients into two groups: (1) PCI with further DEB, and (2) PCI with further drug-eluting stent (DES). Clinical outcomes such as target lesion revascularization, target vessel revascularization, recurrent MI, stroke, cardiovascular mortality, and all-cause mortality were analyzed.ResultsThe patients’ average age was 68.37 ± 11.41 years; 69.2% were male. A total of 75 patients were enrolled in the DEB group, and 42 patients were enrolled in the DES group. The baseline characteristics between the two groups were the same without statistical differences except for gender. Peak levels of cardiac biomarker, pre- and post-PCI cardiac function were similar between two groups. The major adverse cardiac cerebral events rate (34.0% vs. 35.7%; p = 0.688) and cardiovascular mortality rate (11.7% vs. 12.8%; p = 1.000) were similar in both groups.ConclusionsDEB is a reasonable strategy for AMI with ISR. Compared with DES, DEB is an alternative strategy which yielded acceptable short-term outcomes and similar 1-year clinical outcomes.
Highlights
With the improvement of the technology and the design of the stent, the incidence of instent restenosis (ISR) decreased
The 2014 European guideline for coronary revascularization recommends the use of drug-eluting balloon (DEB) for the treatment of in-stent restenosis (ISR) of a bare-metal stent (BMS) or drug-eluting stent (DES) (Class I, level of evidence: B) (Windecker et al, 2014)
The average age of the patients in both groups was similar, but the percentage of males was lower in the DEB group (61.3% vs. 83.3%; p = 0.021)
Summary
With the improvement of the technology and the design of the stent, the incidence of instent restenosis (ISR) decreased. The 2014 European guideline for coronary revascularization recommends the use of DEB for the treatment of ISR of a bare-metal stent (BMS) or drug-eluting stent (DES) (Class I, level of evidence: B) (Windecker et al, 2014). In real-world practice, the use of DEB for either BMS or DES restenosis showed good clinical results (Stella et al, 2011; Lee et al, 2016). Good results of drug-eluting balloon (DEB) use are achieved in in-stent restenosis (ISR) lesions, small vessel disease, long lesions, and bifurcations. We divided our patients into two groups: (1) PCI with further DEB, and (2) PCI with further drugeluting stent (DES). Clinical outcomes such as target lesion revascularization, target vessel revascularization, recurrent MI, stroke, cardiovascular mortality, and all-cause mortality were analyzed. Compared with DES, DEB is an alternative strategy which yielded acceptable short-term outcomes and similar 1-year clinical outcomes
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