Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2018;71:620-7 - Vol. 71 Num.08 DOI: 10.1016/j.rec.2017.08.005

Incidence and predictors of reCurrent restenosis after drug-coated balloon Angioplasty for Restenosis of a drUg-eluting Stent: The ICARUS Cooperation

Salvatore Cassese a,, Bo Xu b, Seiji Habara c, Harald Rittger d, Robert A. Byrne a, Matthias Waliszewski e, María José Pérez-Vizcayno f, Runlin Gao b, Adnan Kastrati a,g, Fernando Alfonso h

a Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, München, Germany
b National Center for Cardiovascular Diseases, Fu Wai Hospital, Beijing, China
c Department of Cardiology, Kurashiki Central Hospital, Okayama, Japan
d Medizinische Klinik I, Klinikum Fürth, Fürth, Germany
e Medical Scientific Affairs, B. Braun Vascular Systems, Berlin, Germany
f Fundación Interhospitalaria de Investigación Cardiovascular, Hospital Universitario Clínico San Carlos, Madrid, Spain
g German Centre for Cardiovascular Research (Deutsche Zentrum für Herz-Kreislauf-Forschung, DZHK), partner site Munich Heart Alliance, München, Germany
h Servicio de Cardiología, Hospital Universitario de La Princesa, Madrid, Spain

Refers to

Keywords

Angiography. Coronary artery disease. Drug-coated balloon. Drug-eluting stent. Restenosis.

Abstract

Introduction and objectives

The incidence and predictors of recurrent restenosis after drug-coated balloon (DCB) angioplasty for drug-eluting stent (DES) restenosis remain poorly studied. We sought to evaluate the incidence and predictors of recurrent restenosis among participants in randomized controlled trials receiving DCB angioplasty for DES restenosis.

Methods

The clinical and lesion data of individuals enrolled in 6 randomized controlled trials of DCB angioplasty for DES restenosis were pooled. All patients included in this report were assigned to receive paclitaxel-coated balloon angioplasty with the SeQuent Please DCB (B Braun, Melsungen, Germany). The current analysis focused on participants with available follow-up angiography at 6 to 9 months. The incidence of recurrent restenosis, defined as diameter restenosis ≥ 50% in the in-segment area at follow-up angiography, and its clinical and angiographic predictors were evaluated.

Results

A total of 546 patients were combined in a single dataset. Angiographic follow-up at 6 to 9 months was available for 484 patients (88.6%) with 518 treated lesions. Recurrent restenosis was detected in 101 (20.8%) patients. On multivariable analysis, lesion length (OR, 1.58; 95%CI, 1.10-2.26; P = .012 for 5 mm increase) and vessel size (OR, 1.42; 95%, 1.12-1.79; P = .003 for 0.5 mm reduction) were independently associated with recurrent restenosis.

Conclusions

In the largest cohort to date of individuals with angiographic surveillance after DCB angioplasty for DES restenosis, we demonstrated that recurrent restenosis occurs in approximately 1 out of 5 patients. Predictors of recurrent restenosis are increased lesion length and small vessel size.

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1885-5857/© 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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