What does this research mean for the field?

The use of adjunctive plaque-modification devices for in-stent restenosis, particularly intravascular lithotripsy, has risen sharply in the United States but is associated with higher in-hospital complication rates compared to conventional balloon angioplasty. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To assess national adoption patterns and in-hospital clinical outcomes of adjunctive plaque-modification strategies compared with conventional balloon angioplasty in patients undergoing percutaneous coronary intervention for in-stent restenosis.

September 12, 2026Circulation Cardiovascular Interventions

Contemporary Trends for the Treatment of In-Stent Restenosis in the United States, 2009 to 2024

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Authors

HSHusam M. Salah TATess Allan TGTyler Gillikin

Discussion

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Overview

Observational registry study reveals rising use of plaque-modification devices with higher in-hospital complications for in-stent restenosis, highlighting their deployment in complex coronary lesions.

Key Points

To assess national adoption patterns and in-hospital clinical outcomes of adjunctive plaque-modification strategies compared with conventional balloon angioplasty in patients undergoing percutaneous coronary intervention for in-stent restenosis.
Analyzed 1,065,354 in-stent restenosis admissions (1,182,599 lesions) in the US National Cardiovascular Data Registry CathPCI Registry from July 2009 through June 2024.
Categorized interventions into conventional plain old balloon angioplasty versus adjunctive therapy, defined as excimer laser atherectomy, intravascular lithotripsy, rotational or orbital atherectomy, or cutting/scoring balloons.
Evaluated adjusted in-hospital clinical outcomes using multivariable logistic regression models clustered by operator.
Adjunctive plaque-modification devices were utilized in 26.5% of cases overall, increasing from 20.8% in early 2018 to 40.7% by mid-2024, driven primarily by rapid intravascular lithotripsy adoption reaching 16.1% of cases.
Adjunctive therapy was associated with higher adjusted odds of in-hospital mortality (OR 1.25, 95% CI 1.19–1.31), myocardial infarction (OR 1.30, 95% CI 1.24–1.35), bleeding (OR 1.29, 95% CI 1.26–1.33), and stroke (OR 1.11, 95% CI 1.02–1.22).
Recurrent in-stent restenosis occurred in 14.3% of procedures and received adjunctive therapy more often than initial restenosis (34.2% vs. 25.0%), while exhibiting lower absolute complication rates.

Cite This Study

Salah et al. (2026) studied this question.

synapsesocial.com/papers/6aa51f49327956e4761f994f https://doi.org/10.1161/circinterventions.126.016533

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September 12, 2026Circulation Cardiovascular Interventions

Contemporary Trends for the Treatment of In-Stent Restenosis in the United States, 2009 to 2024

View Full Paper

Ask AI

Bookmark

Authors

HSHusam M. Salah TATess Allan TGTyler Gillikin

Discussion

Member takes

Overview

Key Points

To assess national adoption patterns and in-hospital clinical outcomes of adjunctive plaque-modification strategies compared with conventional balloon angioplasty in patients undergoing percutaneous coronary intervention for in-stent restenosis.
Analyzed 1,065,354 in-stent restenosis admissions (1,182,599 lesions) in the US National Cardiovascular Data Registry CathPCI Registry from July 2009 through June 2024.
Categorized interventions into conventional plain old balloon angioplasty versus adjunctive therapy, defined as excimer laser atherectomy, intravascular lithotripsy, rotational or orbital atherectomy, or cutting/scoring balloons.
Evaluated adjusted in-hospital clinical outcomes using multivariable logistic regression models clustered by operator.
Adjunctive plaque-modification devices were utilized in 26.5% of cases overall, increasing from 20.8% in early 2018 to 40.7% by mid-2024, driven primarily by rapid intravascular lithotripsy adoption reaching 16.1% of cases.
Adjunctive therapy was associated with higher adjusted odds of in-hospital mortality (OR 1.25, 95% CI 1.19–1.31), myocardial infarction (OR 1.30, 95% CI 1.24–1.35), bleeding (OR 1.29, 95% CI 1.26–1.33), and stroke (OR 1.11, 95% CI 1.02–1.22).
Recurrent in-stent restenosis occurred in 14.3% of procedures and received adjunctive therapy more often than initial restenosis (34.2% vs. 25.0%), while exhibiting lower absolute complication rates.

Cite This Study

Salah et al. (2026) studied this question.

synapsesocial.com/papers/6aa51f49327956e4761f994f https://doi.org/10.1161/circinterventions.126.016533

View Full Paper

Ask AI

Bookmark