ANALYSIS OF INTRACORONARY IMAGING-GUIDED PERCUTANEOUS CORONARY STENTING VERSUS DRUG-COATED BALLOONS IN IMPROVING RECANALIZATION IN RESTENOSIS VESSELS

Abstract

Objectives:                                                                                                                 

To compare the efficacy of intracoronary imaging-guided percutaneous coronary stenting (PCI) versus drug-coated balloons (DCBs) in improving Recanalization in Restenosis Vessels.

Materials and Methods:  This RCT, approved by the hospital's ethical committee, involved 130 patients who provided informed consent. They were randomly assigned in a 1:1Muhammad hasnain iqbal

Senior registrar cardiology

Hbs medical and dental college islamabad ratio to either Group A (imaging-guided PCI) or Group B (DCB). Group A underwent PCI with stent placement guided by intracoronary imaging (IVUS or OCT) to ensure optimal stent placement, while Group B received angioplasty with a drug-coated balloon (paclitaxel or sirolimus) to minimize vessel injury. Statistical analysis was performed using SPSS Version 25.

Results: In this study of 130 patients (mean age 55.27±9.13 years), Group A had 52.3% males, while Group B had 55.4% males. Group A showed a lower target lesion revascularization rate (10.8% vs. 15.4%, p=0.43) and major adverse cardiac events rate (15.4% vs. 20.0%, p=0.49) compared to Group B. Group A also had significantly less late lumen loss (0.29±0.03 mm vs. 0.33±0.04 mm, p=0.00) and a lower rate of in-stent thrombosis (1.5% vs. 3.1%, p=0.55). Procedural success rates were 96.9% for Group A and 93.8% for Group B (p=0.40).

Conclusion: It was concluded that both intracoronary imaging-guided PCI and DCBs have distinct benefits in treating restenosis: imaging-guided PCI may be more effective for immediate recanalization, while DCBs are favorable for long-term restenosis prevention with a reduced risk of thrombotic complications. The choice between these strategies should be tailored to the patient's clinical profile, lesion characteristics, and the specific risks and benefits. Future research should include long-term randomized trials to further compare these approaches and enhance treatment guidelines.