Association between tissue characteristics evaluated with optical coherence tomography and mid-term results after paclitaxel-coated balloon dilatation for in-stent restenosis lesions: a comparison with plain old balloon angioplasty

Abstract

Morphological assessment of ISR tissue using OCT might be useful for identifying ISR lesions favourable for PCB dilatation.

In-stent restenosis assessed with frequency domain optical coherence tomography shows smooth coronary arterial healing process in second-generation drug-eluting stents

“…The paclitaxel-coated balloon therefore is effective for these types of layered neointima. (15) In the present study, the homogeneous and heterogeneous patterns were nearly fixed in the early and late phase secondgeneration DES ISR. However, in the late phase, the heterogeneous pattern with attenuation decreased in second-generation DES ISR.…”

Efficacy of drug‐coated balloon angioplasty in early versus late occurring drug‐eluting stent restenosis: A pooled analysis from the randomized ISAR DESIRE 3 and DESIRE 4 trials

“…In the current analysis, DCB's predominant paclitaxel based antiproliferative and antimigratory mode of action, 18 is associated with inferior antirestenotic efficacy in early DES‐ISR as compared to late‐ISR. Only a few studies evaluated the association of tissue characteristics and clinical efficacy of ISR treatment strategies in ISR, reporting favorable results in lesions with homogeneous tissue backscatter of antiproliferative drug‐based treatment strategies, repeat DES implantation and DCB as compared to POBA 19,20 . Therefore, the results of the current analysis, showing significant higher clinical event rates at 12 months in early ISR are somewhat surprising.…”

Association between tissue characteristics assessed with optical coherence tomography and mid-term results after percutaneous coronary intervention for in-stent restenosis lesions: a comparison between balloon angioplasty, paclitaxel-coated balloon dilatation, and drug-eluting stent implantation

“…Procedures for PCI and OCT were previously reported. 2 Cardiac catheterization was performed using a 6 or 7-F sheath and guiding catheter via the trans-radial or brachial approach. Intravenous heparin ( 100 U/kg adjusted depending on age) and intra-coronary nitrates were administered at the beginning of the procedure.…”

“…Recently, we reported that ISR and target lesion revascularization (TLR) rates in ISR lesions with a homogeneous structure, high backscatter, and non-lipid-rich intima treated with a paclitaxel-coated balloon (PCB) were significantly lower than those in ISR lesions treated with plain old balloon angioplasty (POBA). 2 However, it is not known whether there is a difference in the effectiveness of a drug-eluting stent according to tissue characterization assessed with OCT compared with PCB and POBA.…”