D-58 | Meta Analysis comparing Drug Coated Balloon versus Balloon Angioplasty for patients presenting with coronary in-stent restenosis

Despite the advent of newer stents, in-stent restenosis has been a persistent and formidable challenge. Trials have demonstrated superiority of drug coated balloons (DCB) over balloon angioplasty (BA). Therefore we conducted a meta-analysis aimed at elucidating their respective clinical outcomes. A literature search using MEDLINE (EMBASE and PubMed) using a systematic search strategy by PRISMA till November 01, 2023. CRAN-R software was used for statistical analysis. The quality assessment was performed using the Cochrane Risk of Bias tool. We included 6 studies with a total of 1171 patients. Our analysis showed decreased odds of multiple outcomes with statistically significant results including target vessel re-vascularization (OR 0.33, CI 0.19-0.57), target vessel failure (OR 0.30, CI 0.09-0.99), target lesion re-vascularization (OR 0.22, CI 0.10-0.46), restenosis (OR 0.1343, CI 0.06-0.27), and major adverse cardiac events (OR 0.2, CI 0.12-0.37) in the DCB arm. Although myocardial infarction (MI) and all-cause mortality showed decreased odds in the DCB arm, with all-cause mortality 0.8 (CI 0.363-2.09), and MI at 0.6 (CI 0.0349-1.07), the reductions did not reach statistical significance. Our study favored DCB over BA in management of in-stent coronary restenosis.