Abstract:

Objective   To compare the efficacy and safety of drug-eluting stents(DES) implantation and vascular brachytherapy(VBT) for in-stent restenosis(ISR). Methods   Controlled trials of DES versus VBT for in-stent restenosis were collected by literature search method and Meta-analysis was performed by using Review Manager software version 5.1. Results   13 controlled trials with 2312 patients were included. Of the 2312 patients, 1259 were in the DES group and 1053 were in the VBT group. Meta-analysis indicated that, the incidence of binary restenosis (P＜0.00001), late lumen loss (P＜0.00001), target-vessel revascularization (TVR)(P=0.03) and adverse cardiac event (MACE)(P=0.004) in the DES group were significantly lower compared with those of the VBT group. There were no significant differences in the incidence and mortality of late stent thrombosis between the two groups. Conclusion   Drug-eluting stents are markedly superior to VBT for the treatment of ISR in binary restenosis, late lumen loss,TVR reduction, but not in late stent thrombosis and mortality reduction.

Key words: Drug-eluting stents; Vascular brachytherapy; In-stent restenosis; Meta-analysis