Drug-Eluting Stent, Drug-Coated Balloon, or Plain Old Balloon Angioplasty for In-Stent Coronary Restenosis: Insights From a Mixed Treatment Comparison Meta-Analysis of Randomized Trials
Authors' conclusion
In patients with ISR, DCB reduced major adverse cardiovascular events/target lesion revascularization compared with POBA. There was no significant difference in clinical outcomes between DCB and DES.
Study context
- Population
- Patients with coronary in-stent restenosis (ISR)
- Participants
- 3,820 patients · 18 RCTs
- Comparison
- Drug-eluting stent (DES) vs DCB vs plain old balloon angioplasty (POBA) for coronary ISR
Methodological detailsmixed treatment comparison
- Mixed treatment comparison
Pooled result
As reported in the abstract
MACE · mean follow-up 18 months
Each group vs POBAOdds ratio (95% CI)
DCB
0.34(0.24–0.50)
DES
0.37(0.25–0.54)
Further pooled results
| Outcome | OR (95% CI) | |
|---|---|---|
| Target lesion revascularization · mean follow-up 18 months — DCB vs POBA | 0.28 (0.15–0.50) | |
| Target lesion revascularization · mean follow-up 18 months — DES vs POBA | 0.21 (0.10–0.42) | |
| 0.10.31310Odds ratio (log scale) |
| Outcome | Mean difference (mm) (95% CI) | |
|---|---|---|
| Late lumen loss | −0.16 (−0.29 to −0.04) | |
| −0.4−0.200.2Difference, mm (linear scale) |
Postprocedure minimum lumen diameter; other clinical outcomes (DCB vs DES)
- DCB had a lower postprocedure minimum lumen diameter than DES
- No difference in other clinical outcomes between DCB and DES
Original publication
Drug-Eluting Stent, Drug-Coated Balloon, or Plain Old Balloon Angioplasty for In-Stent Coronary Restenosis: Insights From a Mixed Treatment Comparison Meta-Analysis of Randomized Trials. Circ Cardiovasc Interv. Published 12 November 2025. doi:10.
Summarised from the published abstract; every number is checked against it