Which Treatment Is Most Effective for In-Stent Restenosis?

Treatment of coronary in-stent stenosis has evolved over time, but direct comparisons of the seven current therapeutic options are lacking. To determine which approach is most effective, Italian researchers conducted a hierarchical Bayesian network meta-analysis of 24 randomized, controlled trials that involved 4880 patients and included all currently available interventional strategies. Most trials were powered for angiographic endpoints.

Compared with plain balloons, all other approaches — bare metal stents, brachytherapy, rotational atherectomy, cutting balloons, drug-coated balloons, and drug-eluting stents — were associated with reduced late lumen loss as well as lower rates of target lesion revascularization (TLR) and other major adver…