Abstract:

Objective To investigate the efficacy of drug⁃coated balloon（DCB）versus drug⁃eluting stent （DES）for the treatment of in⁃stent restenosis（ISR）with heterogeneous neointimal pattern. Methods In⁃stent restenosis patients with heterogeneous neointimal pattern who had been confirmed by coronary angiography and optical coherence tomography from January 2017 to December 2018 were retrospectively studied. The patients were assigned to DCB group（n = 6）or DES group（n = 12）according to the therapeutic strategies. The clinical data were collected. Major adverse cardiovascular events（MACEs）including cardiac death，nonfatal myocardial infrac⁃ tion，target vessel revascularization，and stent thrombosis were recorded during the period of follow ⁃ up. Results The clinical baseline data had no statistical difference between DCB group and DES group（P > 0.05）. The target vessels showed by coronary angiography and the diameter of the preoperative reference vessels，length of lesions， and degree of stenosis did not differ statistically the two groups（P > 0.05）. The percentage of residual stenosis was postoperatively higher（P < 0.05）in DCB group than in DES group；there were no statistical difference in the areas of in ⁃stent，vascular lumen and neointima，neointimal load，lipid plaque，and thrombus ratio between the two groups（P > 0.05）；the area of vascular lumen was larger in DES group than in DCB group（P < 0.05）. The follow⁃period last 14（13，16.5）months in DCB group and 20（16，24）months in DCB group. No MACEs occurred in both groups during the follow⁃up period. Conclusions Both DCB and DES are safe and effective in treatment of IRS with heterogeneous neointimal pattern.

Key words:

in ? stent restenosis, heterogeneous intima, drug ? coated balloon, drug ? eluting stent, optical coherence tomography