Introduction
Methods
Patients and study design
Interventions
Follow-up
Angiographic follow-up
Statistical analysis
Results
Seal-wing PEB | Iopromide-coated PEB | EES |
p
| ||
---|---|---|---|---|---|
Seal-wing vs. iopromide- PEB | Seal-wing PEB vs. EES | ||||
Demographic parameters | |||||
Patients/ ISR lesions, n | 64/69 | 68/74 | 68/74 | ||
Male/female | 49 (76.56%)/ | 43 (63.24%)/ | 46 (67.65%)/ | 0.288c
| 0.762c
|
15 (23.44%) | 25 (36.74%) | 22 (32.35%) | |||
Age, years | 65.25 ± 11.01a
| 65.6 ± 10.9a
| 65.5 ± 10.6a
| 1.000d
| 1.000d
|
Body mass index, kg/m2
| 28.38 ± 4.93a/21.19b
| 28.7 ± 4.0a/19.23b
| 29.3 ± 4.2a/18.61b
| 1.000f
| 0.255f
|
Ejection fraction, % | 52.31 ± 10.01a/55.00b
| 49.74 ± 11.95a/50.0b
| 49.57 ± 11.44a/50.0b
| 0.732f
| 0.729f
|
Diabetes mellitus | 18 (28.12%) | 17 (25.00%) | 18 (26.47%) | 1.000c
| 1.000c
|
Renal insufficiency | 2 (3.12%) | 2 (2.94%) | 7 (10.29%) | 1.000e
| 0.495e
|
CABG | 6 (9.38%) | 3 (4.41%) | 6 (8.82%) | 1.000e
| 1.000e
|
Ever smoked | 31 (48.44%) | 31 (45.59%) | 29 (42.65%) | 1.000e
| 1.000c
|
Previous MI | 31 (48.44%) | 43 (63.24%) | 41 (60.29%) | 0.117c
| 0.258c
|
2VD/3VD | 43 (67.19%) | 38 (55.88%) | 41 (60.29%) | 1.000c
| 1.000c
|
Multi ISR | 5 (7.81%) | 4 (5.88%) | 5 (7.35%) | 1.000e
| 1.000c
|
Baseline PCI | |||||
ACSy (STEMI/NSTEMI) | 37 (57.81%) | 45 (66.18%) | 50 (73.53%) | 0.966c
| 0.171c
|
stable AP | 27 (42.19%) | 23 (33.82%) | 18 (26.47%) | ||
Type of lesion | |||||
B2/C | 47 (68.12%) | 51 (68.92%) | 47 (63.51%) | 1.000c
| 1.000c
|
Lesion localization | |||||
LAD/RD | 34 (49.28%) | 35 (47.30%) | 40 (54.05%) | 1.000e
| 1.000e
|
RCx/OM | 15 (21.74%) | 16 (21.62%) | 10 (13.51%) | ||
RCA | 18 (26.09%) | 22 (29.73%) | 22 (29.73%) | ||
SVG | 2 (2.9%) | 1 (1.35%) | 2 (2.70%) | ||
Diameter of the previous stent, mm | 3.09 ± 0.48a/3.00b
| 3.18 ± 0.43a/3.0b
| 3.20 ± 0.41a/3.0b
| 0.390f
| 0.225f
|
Length of the previous stent, mm | 25.67 ± 15.48a/20.00b
| 22.65 ± 11.70a/19.0b
| 19.39 ± 9.27a/16.0b
| 0.720f
| 0.012f
|
In-stent restenosis | |||||
ACSy, STEMI/NSTEMI | 19 (29.69%) | 24 (35.29%) | 25 (36.76%) | 1.000e
| 0.333c
|
Stable AP | 42 (65.62%) | 41 (60.29%) | 33 (48.53%) | ||
Other, silent ischemia | 4 (6.25%) | 3 (4.41%) | 10 (14.71%) | ||
Time to ISR, months | 12.49 ± 11.06a/7.00b
| 12.10 ± 8.47a/9.0b
| 16.51 ± 9.49a/24.0b
| 1.000f
| 0.042f
|
Type of ISR | |||||
I (focal; all) | 25 (36.23%) | 30 (40.54%) | 21 (28.38%) | 1.000e
| 1.000e
|
II (diffuse) | 33 (47.83%) | 34 (45.95%) | 35 (47.30%) | ||
III (proliferative) | 6 (8.7%) | 5 (6.76%) | 8 (10.81%) | ||
IV (occlusion) | 5 (7.25%) | 5 (6.76%) | 10 (13.51%) | ||
Periprocedural parameters | |||||
Cutting predilatation | 20 (28.99%) | 16 (21.62%) | 5 (6.76%) | 0.933c
| 0.002c
|
ISR; PEB/EES diameter, mm | 3.27 ± 0.47a/3.17b
| 3.32 ± 0.39a/3.5b
| 3.31 ± 0.43a/3.5b
| 1.000f
| 1.000f
|
ISR; PEB/EES length, mm | 23.19 ± 12.98a/20.00b
| 22.53 ± 8.13a/20.0b
| 28.47 ± 12.76a/24.0b
| 1.000f
| 0.0003f
|
Postdilatation, atm | 13.48 ± 2.34a/12.00b
| 14.84 ± 2.77a/16.0b
| 14.11 ± 2.45a/12.0b
| 0.009f
| 0.411f
|
Second stent implantation | 8 (11.59%) | 11 (14.86%) | 11 (14.86%) | 1.000c
| 1.000c
|
Crossover to DES | 2 (2.9%) | 2 (2.7%) | - | 1.000c
| - |
Seal-wing PEB | Iopromide-coated PEB | EES |
p
| |||
---|---|---|---|---|---|---|
Seal-wing vs. iopromide- PEB | Seal-wing PEB vs. EES | |||||
Patients/lesions, n | 59/64 | 63/69 | 62/68 | |||
Preprocedural Parameters - ISR | ||||||
Minimal lumen diameter, mm | Mean | 0.86 | 0.92 | 0.79 | 1.000a
| 0.732a
|
SD | 0.46 | 0.45 | 0.48 | |||
Median | 0.93 | 1.00 | 0.77 | |||
Reference diameter, mm | Mean | 2.50 | 2.64 | 2.66 | 0.240a
| 0.087a
|
SD | 0.43 | 0.47 | 0.45 | |||
Median | 2.45 | 2.63 | 2.66 | |||
% Diameter stenosis | Mean | 74.3 | 71.8 | 78.0 | 0.939a
| 0.372a
|
SD | 14.5 | 13.9 | 13.4 | |||
Median | 73.0 | 70.0 | 76.0 | |||
Post-procedural Parameters - Post re-PCI | ||||||
Minimal lumen diameter, mm | Mean | 2.09 | 2.18 | 2.51 | 1.000a
| <0.0001a
|
SD | 0.45 | 0.39 | 0.38 | |||
Median | 1.99 | 2.13 | 2.49 | |||
Reference diameter, mm | Mean | 2.72 | 2.79 | 3.01 | 0.756a
| 0.0003a
|
SD | 0.42 | 0.41 | 0.40 | |||
Median | 2.63 | 2.79 | 2.96 | |||
Acute gain, mm | Mean | 1.23 | 1.25 | 1.72 | 1a
| <0.0001a
|
SD | 0.53 | 0.54 | 0.47 | |||
Median | 1.19 | 1.12 | 1.69 | |||
% Diameter residual stenosis | Mean | 21.5 | 19.5 | 16.3 | 0.153a
| <0.0001a
|
SD | 7.9 | 7.4 | 5.9 | |||
Median | 23.5 | 20.0 | 16.0 | |||
12-month QCA parameters | ||||||
Minimal lumen diameter, mm | Mean | 1.63 | 2.09 | 2.07 | 0.0006a
| 0.003a
|
SD | 0.78 | 0.57 | 0.80 | |||
Median | 1.68 | 2.13 | 2.23 | |||
Reference diameter, mm | Mean | 2.62 | 2.81 | 2.96 | 0.039a
| 0.0003a
|
SD | 0.53 | 0.48 | 0.50 | |||
Median | 2.56 | 2.81 | 2.86 | |||
% Diameter stenosis | Mean | 42.4 | 26.2 | 30.9 | <0.0001a
| 0.009a
|
SD | 27.9 | 18.0 | 24.6 | |||
Median | 33.5 | 22.0 | 21.5 | |||
Late lumen loss, mm | Mean | 0.47 | 0.09 | 0.44 | <0.0001a
| 1.000 |
SD | 0.57 | 0.44 | 0.73 | |||
Median | 0.30 | 0.02 | 0.19 | |||
Binary restenosis (%DS˃50%) | (n/%) | 18 (28.12%) | 6 (8.7%) | 13 (19.12%) | 0.012b
| 0.666b
|
Seal-wing PEB | Iopromide-coated PEB | EES |
p
| |||
---|---|---|---|---|---|---|
Seal-wing vs. iopromide- PEB | Seal-wing PEB vs. EES | |||||
Patients/lesions, n | 63/64 | 68/74 | 68/74 | |||
MACE all, n(%) | 17 (26.98%) | 7 (10.29%) | 13 (19.12%) | 0.003a
| 0.102a
| |
CV death, n(%) | 0 | 1 (1.47%) | 1 (1.47%) | 1.000b
| 1.000b
| |
AIM, n(%) | 4 (6.35%) | 1 (1.47%) | 1 (1.47%) | 0.468b
| 0.468b
| |
TVR, n(%) | 13 (20.63%) | 5 (7.35%) | 11 (16.18%) | 0.009a
| 0.360a
| |
Event-free survivors, n(%) | 46 (73.02%) | 61 (89.71%) | 55 (80.88%) | 0.027a
| 0.666a
| |
AP (CCS), n(%) | 0–1 | 38 (82.61%) | 48 (78.69%) | 43 (78.18%) | 1.000b
| 1.000b
|
2 | 7 (15.22%) | 13 (21.31%) | 12 (21.82%) | |||
NYHA, n(%) | 1 | 13 (28.26%) | 14 (22.95%) | 20 (36.36%) | 1.000b
| 1.000b
|
2 | 31 (67.39%) | 44 (72.13%) | 31 (56.36%) | |||
3 | 2 (4.35%) | 3 (4.92%) | 4 (7.27%) |
Seal-wing PEB | Iopromide-coated PEB | EES | Seal-wing vs. iopromide- PEB | Seal-wing PEB vs. EES | ||
---|---|---|---|---|---|---|
Diabetes mellitus | pa
| |||||
Patients/lesions, n
| 18/19 | 16/16 | 15/16 | 0.024 | 0.450 | |
Late lumen loss, mm | Mean | 0.64 | 0.12 | 0.48 | ||
SD | 0.63 | 0.33 | 0.86 | |||
Median | 0.33 | 0.06 | 0.12 | |||
ISR length >10 mm | ||||||
Patients/lesions, n
| 36/41 | 42/44 | 44/47 | 0.0006 | 1.000 | |
Late lumen loss, mm | Mean | 0.53 | 0.16 | 0.53 | ||
SD | 0.57 | 0.50 | 0.67 | |||
Median | 0.37 | 0.05 | 0.26 | |||
Vessel diameter < 3 mm | ||||||
Patients/lesions, n
| 49/53 | 49/54 | 47/52 | <0.0001 | 0.564 | |
Late lumen loss, mm | Mean | 0.53 | 0.12 | 0.42 | ||
SD | 0.60 | 0.48 | 0.63 | |||
Median |
0.37
| 0.05 | 0.16 |
Logistic regression analysis | |||
---|---|---|---|
p
| Unadjusted OR | 95% CI | |
Diabetes mellitus (1 = yes, 0 = no) | 0.029 | 3.018 | 1.117–8.156 |
Type B2/C lesion (1 = yes, 0 = no) | 0.172 | 2.200 | 0.709–6.825 |
Vessel diameter < 3 mm (1 = yes,0 = no) | 0.611 | 1.354 | 0.422–4.348 |
ISR length > 10 mm (1 = yes, 0 = no) | 0.245 | 1.778 | 0.673–4.694 |
Multivariate logistic regression analysis | |||
p
| adjusted OR | 95% CI | |
ISR length > 10 mm (1 = yes, 0 = no) | 0.048 | 3.375 | 1.011–11.270 |