The effectiveness and safety of paclitaxel-coated balloons in elderly patients with coronary in-stent restenosis

Abstract

Objective To assess the effectiveness and safety of paclitaxel-coated balloons for in-stent restenosis in patients aged 65 years and over. Methods Sixty elderly patients(≥65 years old)with in-stent restenosis were enrolled at the Department of Cardiology, the First Affiliated Hospital of Inner Mongolian Medical University.Based on different treatment methods for in-stent restenosis, patients were divided into the drug-eluting balloon(DEB, n=32)group and the drug-eluting stent(DES, n=28)group.The primary end point was late luminal loss, determined by angiography.Secondary end points included rates of restenosis and major adverse cardiac events(MACEs). Results Quantitative coronary angiography revealed no significant differences in baseline data.At 3 months after treatment, the rate of MACEs was 28.6% in the DES group and 12.5% in the DEB group(P<0.05). At 6 months after treatment, angiography showed that the ±s of in-segment late luminal loss was(0.21±0.04)mm in the DES group versus(0.12±0.06)mm in the DEB group(P<0.05). Furthermore, 7 of 28 patients(25%)in the DES group had restenosis, compared with 4 of 32 patients(12.5%)in the DEB group(P=0.03). Conclusions Paclitaxel-coated balloons for coronary in-stent restenosis in patients aged 65 years or over can significantly reduce the incidence of restenosis and lower the rate of MACEs.The procedure is safe with no serious complications, eliminates the need for additional stent implantation, and should be further assessed in future clinical trials. Key words: Coronary restenosis; Drug coated balloon; Angioplasty, balloon