Treatment of in-stent restenosis with ultrathin-strut versus thin-strut drug-eluting stents or drug-eluting balloons: a multicentre registry
Authors' conclusion
Ultrathin DES were associated with reduced DOCE, TLR and TVR risks in diffuse ISR compared to DEBs.
Study context
- Population
- Patients with DES in-stent restenosis (DEB Dragon and ULTRA registries)
- Participants
- 269 / 541 / 557
- Exposure
- Ultrathin-strut DES vs thin-strut DES vs DEB for DES in-stent restenosis
- Ultrathin DESn = 269
- Thin-strut DESn = 541
- DEBn = 557reference
- Outcome
- DOCE (cardiac death, TLR, target vessel MI), TLR and TVR
- Follow-up
- 3 years
Methodological detailsmulticentre, propensity score matching, inverse probability weighting
- Multicentre
- Propensity score matching
- Inverse probability weighting
Main finding
As reported in the abstract
DOCE, TLR, TVR (IPW-adjusted overall cohort)
Hazard ratio (95% CI)P value
Ultrathin DESvs DEBDOCE
0.353(0.194–0.642)
P < 0.001Ultrathin DESvs Thin-strut DESDOCE
0.645(0.457–0.911)
P = 0.013Ultrathin DESvs DEBTLR
0.184(0.081–0.417)
P < 0.001Ultrathin DESvs DEBTVR
0.188(0.093–0.379)
P < 0.001Thin-strut DESvs DEBTLR
0.686(0.407–1.157)
P = 0.157Thin-strut DESvs DEBTVR
0.706(0.453–1.101)
P = 0.124Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| DOCE, TLR, TVR in diffuse ISR (subgroup)Ultrathin DESvs DEBDOCE | 0.364 (0.188–0.705) | P = 0.003 | |
| DOCE, TLR, TVR in diffuse ISR (subgroup)Thin-strut DESvs DEBDOCE | 0.602 (0.367–0.987) | P = 0.044 | |
| DOCE, TLR, TVR in diffuse ISR (subgroup)Ultrathin DESvs DEBTLR | 0.220 (0.091–0.531) | P < 0.001 | |
| DOCE, TLR, TVR in diffuse ISR (subgroup)Ultrathin DESvs DEBTVR | 0.241 (0.113–0.513) | P < 0.001 | |
| 0.050.21520Hazard ratio (log scale) |
Device-oriented composite endpoints (DOCE), TLR, TVR in diffuse in-stent restenosis (ISR) (subgroup)
- TLR and TVR reduction achieved only by ultrathin DES
Original publication
Treatment of in-stent restenosis with ultrathin-strut versus thin-strut drug-eluting stents or drug-eluting balloons: a multicentre registry. EuroIntervention. Published 4 November 2024. doi:10.
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