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Panminerva Medica 2021 Nov 11

DOI: 10.23736/S0031-0808.21.04573-0


language: English

Paclitexel versus sirolimus-coated balloon in the treatment of coronary instent restenosis

Carlo BRIGUORI 1 , Gabriella VISCONTI 1, Marco GOLINO 1, Amelia FOCACCIO 1, Mario SCARPELLI 1, Silvia NUZZO 2, Giuseppe BIONDI-ZOCCAI 1, 3

1 Interventional Cardiology Unit, Mediterranea Cardiocentro, Naples, Italy; 2 IRCCS SDN, Naples, Italy; 3 Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy

BACKGROUND: Few studies compared paclitaxel-coated balloon (PCB) versus sirolimus-coated balloon (SCB) in the treatment of drug-eluting stent (DES) instent restenosis (ISR).
METHODS: Between November 5 2009 and October 14 2020, in our centre 212 patients with first DES-ISR were treated with PCB (Restore®; Cardionovum GmbH, Bonn, Germany), whereas 230 patients were treated with SCB (Devoir®; MINVASYS SAS, Gennevilliers, France). Following a propensity matching, 186 patients were included into PCB group (PCB group), and in the SCB group (SCB group). The primary purpose of the study was the 1-year target lesion failure (TLF) rate, including cardiac death, target vessel-related myocardial infarction, and repeated target lesion or target vessel revascularization.
RESULTS: Procedural success occurred in all cases. Fully optimal predilation (that is, balloon-to-stent ratio >0.91, time of DCB inflation >60 sec. and residual percent diameter stenosis after lesion preparation <20%) was observed more often in the SCB group (126 [68%] patients versus 106 [57%] patients; p = 0.042). One year TLF occurred in 29 (15.5%) patients in the SCB group and in 32 (17%) patients in the PCB group (OR = 1.12 [0.65-1.95]; p = 0.78). By logistic Cox regression analysis fully optimal predilation (OR = 0.06; 95% confidence interval = 0.01-0.21; p <0.001) but not DCB type (OR = 0.74; 95% confidence interval = 0.41-1.31; p = 0.29) was independent predictor of 1-year TLF.
CONCLUSIONS: The current study suggests that 1-year TLF is not statistically and clinically different in patients with DES ISR treated with a PCB and a SCB.

KEY WORDS: Balloon angioplasty; Drug-eluting balloon; In-stent restenosis

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