Document Detail

Comparison of plain balloon and cutting balloon angioplasty for the treatment of restenosis with drug-eluting stents vs bare metal stents.
MedLine Citation:
PMID:  20679737     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The efficacy of cutting or plain balloon angioplasty (CBA or PBA) has not been analyzed for the treatment of drug-eluting stent (DES) restenosis vs bare metal stent (BMS) restenosis.
METHODS AND RESULTS: The 252 in-stent restenosis (ISR) lesions in 224 consecutive patients treated by CBA (n=167) or PBA (n=85) between July 2002 and December 2007 were analyzed. At 6-month angiographic and 12-month clinical follow-up, CBA and PBA showed similar efficacies: repeat-ISR (37.0% vs 37.8%, P=0.90), late loss (0.62+/-0.60 vs 0.61+/-0.47 mm, P=0.92), and target lesion revascularization (18.3% vs 22.4%, P=0.50). This comparable efficacy was maintained for treatment in the DES-ISR and BMS-ISR subgroups. However, target lesion-related myocardial infarction (n=9) occurred more frequently in the CBA than in the PBA arm (6.2% vs 0%, P=0.03), most of which developed early after ISR treatment (n=7; 54+/-26 days). Independent predictors of repeat-ISR were diffuse ISR and smaller pretreatment minimal lumen diameter, both of which might imply heavier plaque burden in the ISR group.
CONCLUSIONS: Plain or cutting balloon angioplasty for ISR seems to be comparable, as the angiographic or clinical endpoints were not affected by initial stent type but by parameters related to the plaque burden of the ISR lesion. However, CBA might be associated with higher risk of myocardial infarction than PBA, suggesting more attention to dual-antiplatelet therapy after its use for ISR.
Seung-Jung Park; Kyung-Hee Kim; Il-Young Oh; Dong-Ho Shin; Kyung-Il Park; Myung-Ki Seo; Jin-Wook Chung; Kyung Woo Park; Hae-Young Lee; Hyun-Jae Kang; Bon-Kwon Koo; Tae-Jin Youn; Hyo-Soo Kim
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Publication Detail:
Type:  Comparative Study; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-07-29
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  74     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-31     Completed Date:  2010-12-22     Revised Date:  2011-02-18    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1837-45     Citation Subset:  IM    
Cardiovascular Center and Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.
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MeSH Terms
Angioplasty, Balloon / adverse effects,  methods*,  standards
Coronary Restenosis / therapy*
Drug-Eluting Stents / adverse effects,  standards*
Follow-Up Studies
Middle Aged
Myocardial Infarction / etiology
Plaque, Atherosclerotic / etiology
Stents / adverse effects,  standards*
Comment In:
Circ J. 2010 Sep;74(9):1796-7   [PMID:  20702962 ]

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