Treatment with another stent, rather than from a drug-coated or drug-eluting balloon, has been shown to be more effective in treating coronary in-stent restenosis, according to 2 new studies.
The 2 studies, 1 European and 1 Japanese, were published in the Journal of the American College of Cardiology earlier this month.
The 309-patient European Ribs IV clinical trial looked at patients with drug-eluting stent in-stent restenosis, comparing the efficacy of retreatment with drug-eluting balloons and everolimus-eluting stents. Results from the study indicated that patients treated with EES showed an 8% lower rate of cardiac death, myocardial infarction, and target vessel revascularization compared to DEB, with an 8% lower need for target vessel revascularization.
The study concluded that treatment with EES “provided superior long-term clinical and angiographic results compared with DEB.”
In the Japanese study, researchers found that 17% of patients with DES restenosis treated with DCB angioplasty had late restenosis, or restenosis occurring at 18 months, as compared with 2.5% in the group treated for bare-metal stent restenosis.
“While awaiting new data, the strategy of stenting a stent, even if not perceived as particularly elegant, should be the default approach for most lesions presenting with DES restenosis,” Dr Antonio Colombo Of Milan, Italy’s Centro Cuore Columbus and Dr Neil Ruparelia of London’s Imperial College said in an editorial commentary on the new studies.
