Clinical Outcome of Paclitaxel-Coated Balloon Angioplasty Versus Drug-Eluting Stent Implantation for the Treatment of Coronary Drug-Eluting Stent In-Stent Chronic Total Occlusion

• DOI: 10.1007/s10557-022-07363-7
• Publication Date: 2022-08-05T08:16:54Z
• Authors: Yuchao Zhang; Zheng Wu; Shaoping Wang; Tong Liu; Jinghua Liu
• Keywords: Target lesion

In-stent chronic total occlusion (IS-CTO) represents a unique challenge for percutaneous coronary intervention. Whether the optimal treatment IS-CTO is angioplasty with paclitaxel-coated balloons (PCBs) or repeat stenting drug-eluting stents (DESs) unclear. We aimed to evaluate long-term clinical outcome of PCB and DES IS-CTO.We retrospectively included patients who underwent successful from January 2016 December 2019. The primary endpoints were major adverse cardiac events (MACEs), including death, myocardial infarction, target lesion revascularization (TLR). Cox proportional hazards model was performed compare risk MACEs between stenting, further explore prognostic factors IS-CTO.A 214 enrolled: 78 (36.4%) treated 136 (63.6%) respectively. median follow-up 1160 days, observed in 28.2% versus 26.5% (P = 0.784), mainly driven by TLR (21.8% vs. 19.9%, P 0.735). There no significant difference group (hazard ratio [HR] 1.25, 95% confidence interval [CI] 0.64-2.46, 0.512). Multivariate analysis revealed that kidney disease ≥ 3 stent layers independent predictors MACEs, while switching another antiproliferative drug an protective factor (all < 0.05).PCB effective alternative strategy IS-CTO, which had similar outcomes contemporary practice, but both accompanied high rate MACEs. Improving poor prognosis remains challenge.