ABSTRACT
Objective To compare the clinical effect of three methods of treatment for the in-stent restenosis(ISR)after percutaneous coronary intervention(PCI),drug coated balloon(DCB)compared with common balloon and drug eluting stent(DES).Methods From August 2014 to January 2018,95 cases of ISR in the Second Affiliated Hospital of Southeast University were diagnosed by coronary angiography.They were treated with common balloon,DCB or second generation DES.The patients were assigned to the DCB group 25 cases or the second-generation DES group(23 cases)and balloon group(47 cases)according to the therapeutic strategies they accepted.Major adverse cardiac events(MACE)of patients were followed by telephone or hospital visit at 6-12 months.MACE was defined as a composite of cardiac death,nonfatal myocardial infarction(MI),and target vessel revascularization(TVR).Results In summary,95 patients with DES-ISR were enrolled,including 47 patients in the balloon group,23 patients in the DCB group and 25 patients in the second-generation DES group.Coronary angiography was performed 6-12 months after operation.The minimum lumen diameter(MLD)of the DCB group was significantly larger than those of the balloon and DES groups[(1.86 ±0.27)mm vs.(2.16 ±0.43)mm,t =3.57,P =0.00;(1.94 ±0.31)mm vs.(2.16 ± 0.43)mm,t=2.05,P=0.05].The restenosis rate of the DCB group was significantly lower than those of the balloon group and DES group[15 cases(31.91％)vs.2 cases(8.69％),χ2 =4.53,P=0.02;8 cases(32.00％)vs.2 cases(8.69％),χ2 =2.66,P=0.05].The rate of late lumen loss(LLL)in the DCB group was significantly lower than those of balloon group and DES group [(0.67 ±0.28)mm vs.(0.21 ±0.18)mm,t =7.17,P =0.00;(0.43 ± 0.28)mm vs.(0.21 ±0.18)mm,t=3.21,P=0.00].MACE was significantly lower than balloon group and DES group[16 cases(34.04％)vs.1 cases(4.76％),χ2 =7.02,P=0.01;8 cases(32.00％)vs.1 cases(4.76％),χ2 =4.06,P=0.02].Conclusion Drug balloon dilatation in stent restenosis is more effective and safer than common balloon dilatation and re-implantation of drug eluting stents.