Drug-coated balloon angioplasty for drug-eluting stent restenosis: Insight from randomized controlled trials

Figures & data

Figure 1. Flow diagram depicting the selection of studies included in the meta-analysis.

Table I. Characteristics of randomized controlled trials included in the meta-analysis.

		No. of patients			Follow-up period (months)
Author	Trial, Published year	DCB	POBA	DES	Angiographic	Clinical	Primary end-point	Definition of MACE
Habara S, et al. (15)	—, 2011	25	25	—	6	6	Late lumen loss	Death, MI, or TLR
Rittger H, et al. (16)	PEPCA-DES, 2012	72	38	—	6	6	Late lumen loss	Cardiac death, MI, or TLR
Habara S, et al. (17)	—, 2013	53	34	—	6	6	TLF	Death, MI, or TVR
Byrne RA, et al. (18)	ISAR-DESIRE 3, 2013	137	134	131	6–8	12	Diameter stenosis	Death, MI, or TLR
Xu B, et al. (19)	PEPCAD China ISR, 2014	109	—	106	9	12	Late lumen loss	Death, MI, or all-cause revascularization

DCB = drug-coated balloon; DES = drug-eluting stent; MACE = major adverse cardiac event; MI = myocardial infarction; POBA = plain old balloon angioplasty; TLF = target lesion failure; TLR = target lesion revascularization; TVR = target vessel revascularization.

Figure 2. Risk ratios of major adverse cardiac events (primary end-point) associated with drug-coated balloon versus the control treatment in patients with drug-eluting stent restenosis. The size of the data marker is proportional to the weight of the individual studies, measured as the inverse of the variance in the study by the Mantel–Haenszel procedure.

Figure 3. Risk ratios of death (A), myocardial infarction (B), target lesion revascularization (C), and recurrent binary restenosis (D) associated with drug-coated balloon versus the control treatment in patients with drug-eluting stent restenosis. The size of the data marker is proportional to the weight of the individual studies, measured as the inverse of the variance in the study by the Mantel–Haenszel procedure.

Habara S, Mitsudo K, Kadota K, Goto T, Fujii S, Yamamoto H, et al. Effectiveness of paclitaxel-eluting balloon catheter in patients with sirolimus-eluting stent restenosis. JACC Cardiovasc Interv. 2011; 4:149–54.

 PubMed Web of Science ®Google Scholar

Rittger H, Brachmann J, Sinha AM, Waliszewski M, Ohlow M, Brugger A, et al. A randomized, multicenter, single-blinded trial comparing paclitaxel-coated balloon angioplasty with plain balloon angioplasty in drug-eluting stent restenosis: the PEPCAD-DES study. J Am Coll Cardiol. 2012;59:1377–82.

 PubMed Web of Science ®Google Scholar

Habara S, Iwabuchi M, Inoue N, Nakamura S, Asano R, Nanto S, et al. A multicenter randomized comparison of paclitaxel-coated balloon catheter with conventional balloon angioplasty in patients with bare-metal stent restenosis and drug-eluting stent restenosis. Am Heart J. 2013;166:527–33.

 PubMed Web of Science ®Google Scholar

Byrne RA, Neumann FJ, Mehilli J, Pinieck S, Wolff B, Tiroch K, et al. Paclitaxel-eluting balloons, paclitaxel-eluting stents, and balloon angioplasty in patients with restenosis after implantation of a drug-eluting stent (ISAR-DESIRE 3): a randomised, open-label trial. Lancet. 2013;381:461–7.

 PubMed Web of Science ®Google Scholar

Xu B, Gao R, Wang J, Yang Y, Chen S, Liu B, et al. A prospective, multicenter, randomized trial of paclitaxel-coated balloon versus paclitaxel-eluting stent for the treatment of drug-eluting stent in-stent restenosis: results from the PEPCAD China ISR trial. JACC Cardiovasc Interv. 2014;7:204–11.

 PubMed Web of Science ®Google Scholar