Cutting balloon versus conventional balloon angioplasty for the treatment of in-stent restenosis: Results of the restenosis cutting balloon evaluation trial (RESCUT)

Remo Albiero, Sigmund Silber, Carlo Di Mario, Carmelo Cernigliaro, Salvatore Battaglia, Bernhard Reimers, Arian Frasheri, Volker Klauss, Joseph M. Auge, Paolo Rubartelli, Marie Claude Morice, Alberto Cremonesi, Joachim Schofer, Alessandro Bortone, Antonio Colombo

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives The aim of this trial was to compare cutting balloon angioplasty (CBA) with conventional balloon angioplasty (i.e., percutaneous transluminal coronary angioplasty [PTCA]) for the treatment of patients with coronary in-stent restenosis (ISR). Background Retrospective studies suggest CBA might be superior to conventional PTCA in the treatment of ISR. Methods The Restenosis Cutting Balloon Evaluation Trial (RESCUT) is a multicenter, randomized, prospective European trial including 428 patients with all types of ISR (e.g., focal, multifocal, diffuse, proliferative). Results In both groups, the majority of ISR lesions were shorter than 20 mm. The length of restenotic stents was similar (CBA: 18.6 ± 9.7 mm; PTCA: 18.3 ± 8.7 mm). The number of balloons used to treat ISR was lower in the CBA group: only one balloon was used in 82.3% of CBA cases, compared with 75% of PTCA procedures (p = 0.03). Balloon slippage was less frequent in the CBA group (CBA 6.5%, PTCA 25%; p <0.01). There was a trend toward a lower need for additional stenting in the CBA group (CBA 3.9%, PTCA 8.0%; p = 0.07). At seven-month angiographic follow-up, the binary restenosis rate was not different between the groups (CBA 29.8%, PTCA 31.4%; p = 0.82), with a similar pattern of recurrent restenosis. Clinical events at seven months were also similar. Conclusions Cutting balloon angioplasty did not reduce recurrent ISR and major adverse cardiac events, as compared with conventional PTCA. However, CBA was associated with some procedural advantages, such as use of fewer balloons, less requirement for additional stenting, and a lower incidence of balloon slippage.

Original languageEnglish
Pages (from-to)943-949
Number of pages7
JournalJournal of the American College of Cardiology
Volume43
Issue number6
DOIs
Publication statusPublished - Mar 17 2004

Keywords

  • %DS
  • CABG
  • CBA
  • CK
  • Coronary artery bypass graft surgery
  • Creatine kinase
  • Cutting balloon angioplasty
  • In-stent restenosis
  • Intravascular ultrasound
  • ISR
  • IVUS
  • MACE
  • Major adverse cardiac events
  • Minimum lumen diameter
  • MLD
  • Percent diameter stenosis
  • PTCA

ASJC Scopus subject areas

  • Nursing(all)

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