TCT-1023 Comparative Effectiveness of DES, DCB, and BMS for the Treatment of In-Stent Restenosis in Carotid Artery Stents: A Systematic Review and Meta-Analysis

Document Type

Abstract

Publication Date

10-28-2025

Abstract

Background: In-stent restenosis (ISR) following carotid artery stenting is a challenging complication associated with an increased risk of cerebrovascular events. Various endovascular approaches—including drug-eluting stents (DES), drug-coated balloons (DCB), and bare-metal stents (BMS)—are employed for ISR treatment. This study compares the clinical outcomes of these treatment modalities. Methods: A systematic review and meta-analysis of studies from 2005–2024 was conducted. Outcomes included restenosis rate, stroke, target lesion revascularization (TLR), and mortality. Subgroup analyses by patient comorbidities and lesion characteristics were also performed. Results: A total of 12 studies comprising 1,284 patients were included (DES: 478; DCB: 412; BMS: 394). DES had the lowest rate of recurrent ISR (7.2%), followed by DCB (12.8%) and BMS (22.4%). TLR was lowest in the DES group (5.1%) compared to DCB (10.6%) and BMS (17.3%). Stroke and mortality rates were similar across groups. Conclusion: DES appears to offer superior efficacy in preventing recurrent carotid ISR and reducing the need for revascularization. DCBs are a viable alternative in high-risk patients where stenting is undesirable. BMS should be reserved for select cases given higher restenosis and TLR rates. Categories: ENDOVASCULAR: Stroke, Stroke Prevention, Carotid Intervention

Publication Title

Journal of the American College of Cardiology

Volume

86

Issue

17 Supplement

First Page

B437

Last Page

B437

Comments

Transcatheter Cardiovascular Therapeutics held 2025-10-25 to 2025-10-28 in San Francisco, CA

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