A Randomized Comparison of 2 Different Drug-Coated Balloons for In-Stent Restenosis

医学 再狭窄 相继的 临床终点 支架 外科 随机对照试验 置信区间 核医学 内科学 数学 离散数学
作者
Shengwen Liu,Yujie Zhou,Zhujun Shen,Hui Chen,Chunguang Qiu,Guosheng Fu,Hui Li,Zaixin Yu,Qiutang Zeng,Zhanquan Li,Wei Li,Shubin Qiao
出处
期刊:Jacc-cardiovascular Interventions [Elsevier]
卷期号:16 (7): 759-767 被引量:6
标识
DOI:10.1016/j.jcin.2022.12.018
摘要

Although use of drug-coated balloons (DCB) is a promising technique, little is known about the clinical efficacy of the Dissolve DCB in drug-eluting stent (DES) in-stent restenosis (ISR). This study sought to evaluate the efficacy and safety of the Dissolve DCB in patients with DES ISR. This was a prospective, multicenter, randomized, noninferiority trial comparing Dissolve DCB with SeQuent Please DCB in patients with DES ISR. Angiographic and clinical follow-up was planned at 9 months in all patients. The primary endpoint was 9-month in-segment late loss. A total of 260 patients with ISR from 10 Chinese sites were included (Dissolve DCB, n = 128; SeQuent Please DCB, n = 132). Nine-month in-segment late loss was 0.50 ± 0.06 mm with Dissolve DCB vs 0.47 ± 0.07 mm with SeQuent Please DCB; the 1-sided 97.5% upper confidence limit of the difference was 0.18 mm (P for noninferiority = 0.03). Rates of target lesion failure and binary restenosis were numerical higher in the Dissolve DCB cohort compared with the SeQuent Please DCB cohort at 9 months (17.5% vs 10.7%; P = 0.12; 23.4% vs 16.4%; P = 0.19, respectively). At 9 months, major adverse cardiac and cerebrovascular events occurred in 36 patients (28.3%) vs 30 patients (22.9%) in the Dissolve DCB and SeQuent Please DCB groups, respectively. In this head-to-head randomized trial, the Dissolve DCB was noninferior to the SeQuent Please DCB for 9-month in-segment late loss. However, Dissolve DCB with its numerical increase in target lesion failure and binary restenosis warrants assessment in larger clinical trials (A Safety and Efficacy Study of Dissolve™ in Treatment of Coronary In-Stent Restenosis; NCT03373695)
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