The long-term clinical effect of cutting ballon angioplasty for coronary in-stent restenosis

Lee, Seung Hyun; Jeong, Myung Ho; Sim, Doo Sun; Lim, Sang Yeob; Bae, Eun Hee; Hong, Young Joon; Park, Ok Young; Park, Woo Seok; Kim, Ju Han; Kim, In Soo; Choi, Myung Ja; Kim, Weon; Ahn, Young Keun; Cho, Jeong Gwan; Park, Jong Chun; Kang, Jung Chaee; Park, Ok Kyu

Abstract

BACKGROUND: Coronary stent implantation reduced the restenosis rate after percutaneous coronary intervention (PCI) but, still coronary in-stent restenosis (ISR) remains the major problem after PCI. Cutting balloon angioplasty is one of the method for ISR treatment. The purpose of this study is prospectively comparing the effect of cutting balloon angioplasty (CBA) with plain old balloon angioplasty (POBA) for the ISR.
METHODS
A total of 50 patients with ISR, who underwent PCI (randomized CBA or POBA for ISR) from January to December 2001 at Chonnam National University Hospital, were divided into two groups: Group I (n=25: 58.4+/-7.9 years, male 88%) with CBA and Group II (n=25: 58.1+/-8.7 years, male 92%) with POBA. The early luminal gain, late luminal loss, major adverse cardiac event and angiographic restenosis rate were compared.
RESULTS
There were no differences in baseline clinical characteristics of sex, age, ejection fraction, cardiac enzyme, risk factors of atherosclerosis, number of coronary artery lesions, and type of ISR between the groups. The minimal luminal diameters of before and after PCI were 0.83+/-0.34 mm, 2.10+/-0.55 mm in group I and 0.93+/-0.58 mm, 2.08+/-0.79 mm in group II. There were no differences in early luminal gain. All patients underwent follow-up coronary angiogram and the restenosis rate was 32% (8/25) in group I and 28% (7/25) in group II, and late luminal loss were 0.60+/-0.40 mm in group I and 0.65+/-0.61 in group II (p=NS). The major adverse cardiac events during 6-month follow-up developed in 3 cases of group I and 4 cases of group II (p=NS).
CONCLUSION
There were no differences in early and long-term clinical effects after CBA and POBA for the treatment of ISR.