Chinese Journal of Tissue Engineering Research ›› 2020, Vol. 24 ›› Issue (4): 555-560.doi: 10.3969/j.issn.2095-4344.1890

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Clinical outcomes of drug-eluting balloons and drug-eluting stents for the treatment of in-stent restenosis

Xie Xiufeng, Zhang Yue, Qu Ze   

  1. Second District of Geriatrics Center, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, Inner Mongolia Autonomous Region, China
  • Received:2019-05-09 Revised:2019-05-23 Accepted:2019-06-27 Online:2020-02-08 Published:2020-01-04
  • Contact: 张越,主任医师,硕士生导师,内蒙古医科大学附属医院老年医学中心二区,内蒙古自治区呼和浩特市 010050
  • About author:Xie Xiufeng, MD, Associate chief physician, Second District of Geriatrics Center, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, Inner Mongolia Autonomous Region, China

Abstract:

BACKGROUND: A series of studies have shown that both drug-eluting balloons and drug-eluting stents are better than the other treatments for drug-eluting in-stent restenosis lesions, but both of them have limitations.

OBJECTIVE: To evaluate the long-term therapeutic efficacy of drug-eluting balloons and drug-eluting stents in the treatment of coronary in-stent restenosis.

METHODS: A total of 63 patients with in-stent restenosis who received treatment in the First Affiliated Hospital of Inner Mongolia Medical University between January 2016 and December 2017 were included in this study. Among these patients, 32 patients received treatment with drug-eluting balloons (drug-eluting balloon group) and 31 patients were treated with drug-eluting stents (drug-eluting stent group). Coronary artery status before and immediately after surgery, coronary angiography 1 year after surgery, adverse events, and the risk factors of in-stent restenosis were recorded in both groups. The study was approved and supported by the Medical Ethics Committee of Inner Mongolia Medical University. 

RESULTS AND CONCLUSION: All patients were followed up for 1 year. There were no significant differences in minimum in-stent diameter, target vessel diameter, in-stent lumen loss in the late period between patients receiving treatment with drug-eluting balloons and patients receiving drug-eluting stents (all P > 0.05). There were no significant differences in secondary restenosis rate (18% vs.16%, P=0.216), target lesion revascularization rate (6% vs. 6%, P=0.513), and incidence of adverse events (9% vs.10%, P=0.334) between drug-eluting balloon and drug-eluting stent groups. There were two cases of gastrointestinal bleeding in the drug-eluting stent group, and no gastrointestinal bleeding occurred in the drug-eluting balloon group. Significant difference in gastrointestinal bleeding occurred between these two groups (P < 0.01). Multi-factor analysis showed that smoking, diabetes and hyperhomocysteinemia are the risk factors of in-stent restenosis. These results suggest that both drug-eluting balloons and drug-eluting stents are the ideal treatments of in-stent restenosis. In clinical practice, individualized treatment options should be considered based on multiple factors.

Key words: drug-eluting stents, drug-eluting balloon, in-stent restenosis, percutaneous coronary intervention, coronary atherosclerotic heart disease, hyperhomocysteinemia, smoking, diabetes mellitus

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