Comparison of efficacy and safety between sirolimus, paclitaxel, everolimus-eluting stent and drug-eluting balloon on the outcome of patients with diffuse in-stent restenosis after BMS implantation

Abstract

Purpose: The aim of this study is to compare the safety and efficacy of Sirolimus (SES), Paclitaxel (PES), Everolimus-eluting stent (EES) and SeQuent™ Please, a drug-eluting balloon (DEB) on the outcome of patients with diffuse in-stent restenosis (D-ISR) after bare metal stent (BMS) implantation. Methods: A prospective analysis of 1078 patients with 1251 D-ISR lesions (427 SES, 363 PES, 232 EES and 229 DEB) in six high volume Asian centers after successful stent implantation (SES: LAD 45.7%, LCX 27.9%, RCA 26.4%) (PES: LAD 46.0%, LCX 22.9%, RCA 31.1%) (EES: LAD 50.0%, LCX 21.0%, RCA 29.0%) (DEB: LAD 54.0%, LCX 23.0%, RCA 23.0%) was performed. The study endpoints were major adverse cardiac events (MACE) and target lesion revascularization (TLR) at 12 and 24 months. Results: See table for clinical results. View this table: Conclusion: (1) The use of SES, PES, EES and DEB in patients with D-ISR seems to be favorable in terms of in-hospital clinical outcome. (2) Patients treated with DEB showed higher restenosis rate and TLR compared with DES.