Clinical Outcome And Angiographic Assessment Of Different Pattern Of Coronary DES In Stent Restenosis With DCB(Drug Coated Balloon)

BACKGROUND:Treatment of patients with DES ISR still challenging as it is hampered by a high incidence of recurrent restenosis.The PACCOCATH-ISR trail was the first in human study done with DCB and it is also first study for treatment of coronary ISR with DCB.But in this modern era of interventional cardiology DCB has been increasingly used and are established for the treatment of DES-ISR.It is still unclear how effective they are in different pattern of ISR with different treatment approach.Objective:aim to peruse and to analyses the clinical outcomes,efficacy and safety assessment according to the pattern of ISR and treatment procedural approach by DCB.Methods:During the year 2017 and 2018,80 patients' population with DES-ISR treated with DCB were enrolled.This study was prospective single centered non randomized trial.The population of patients assigned were divided into two major groups on the basis of Mehran classification:Focal and Non-focal.Again its further divided into several sub groups on the basis of procedural treatment approach taken during intervention.The primary endpoint was late lumen loss in-segment at 6-month angiographic follow-up.Secondary endpoint included binary restenosis rate and major adverse cardiac events(MACE)at 12-month follow-up.Result:At the 6-month angiographic follow-up(follow-up rate 94%)in segment late lumen loss was(0.27±0.22 mm,focal vs 0.45±0.58 mm,non-focal,p= 0.11).The incidence of recurrent restenosis(3.7%vs 33.3%,p=0.003)and target lesion revascularization(6.9%vs 9.8%,p=1)was lower in focal than non-focal lesion.The cumulative MACE-free survival was didn't differ among the group.Conclusion:-In patient's population which has been assigned for the study shows that DCB with better clinical efficacy,outcome and safety in focal lesion than non-focal where as non-focal lesion is more susceptible to recurrent restenosis.