# Paclitaxel-behandelde ballonnen behouden effectiviteit bij in-stentrestenose, ongeacht nierfunctie

*geplaatst 2026-09-25 · Nierziekte · Circulation. Cardiovascular interventions · doi 10.1161/CIRCINTERVENTIONS.126.016978 · https://hartvaat.nl/2026/09/17/paclitaxel-behandelde-ballonnen-behouden-effectiviteit-bij-in-stentrestenose-ong/*

In een post-hoc analyse van de AGENT IDE-randomisatietrial werd het effect van paclitaxel-behandelde ballonnen (DCB) versus conventionele ballonangioplastiek vergeleken bij patiënten met en zonder chronische nierziekte (CKD) bij de behandeling van in-stentrestenose. Na twee jaar was DCB effectief in het verminderen van target lesion failure bij patiënten met CKD (HR 0,70; 95%-BI 0,35-1,39) ten opzichte van patiënten zonder nierfunctievermindering (HR 0,74; 95%-BI 0,52-1,05), zonder significant interactie-effect (PInt=0,90). Deze resultaten bevestigen dat DCB een betrouwbare interventie is voor in-stentrestenose, ook in de hoge-risicogroep met CKD.

## English: Influence of Chronic Kidney Disease on Outcomes After Paclitaxel-Coated Balloon Angioplasty for Coronary In-Stent Restenosis.

A post hoc analysis of the AGENT IDE randomized trial evaluated paclitaxel-coated balloon (DCB) angioplasty versus conventional balloon angioplasty for coronary in-stent restenosis in patients with and without chronic kidney disease (CKD). At two years, DCB reduced target lesion failure similarly in the CKD subgroup (HR 0.70; 95% CI 0.35-1.39) and the non-CKD group (HR 0.74; 95% CI 0.52-1.05), with no significant interaction (PInt=0.90). These findings confirm that DCB remains an effective and safe treatment option for in-stent restenosis, regardless of baseline renal function.

## Abstract (original, from the publication)

BACKGROUND: Drug-coated balloons (DCB) are superior to conventional balloon angioplasty in coronary in-stent restenosis. The influence of chronic kidney disease (CKD) on outcomes after DCB for in-stent restenosis is not well described. METHODS: A post hoc analysis of the AGENT IDE trial was performed to compare the efficacy and safety of DCB versus balloon angioplasty in patients with CKD (estimated glomerular filtration rate <60 mL/min per 1.73 m2) and those without renal impairment. The primary outcome was target lesion failure, a composite of ischemia-driven target lesion revascularization (TLR), target vessel myocardial infarction, or cardiac death. The 2 cohorts were compared using time-to-first-event and recurrent event methods through 2 years. RESULTS: Of the 406 patients randomized to DCB, 149 (25%) had CKD (mean estimated glomerular filtration rate 47.3±9.2). They were older and had greater multivessel disease and congestive heart failure than those without CKD. There were no differences in clinical presentation, Mehran in-stent restenosis patterns or technical success. The effect of DCB versus balloon angioplasty on 2-year target lesion failure was similar in patients with CKD (23.6% versus 30.0%; hazard ratio, 0.70 [95% CI, 0.35-1.39]) compared with those without CKD (28.1% versus 34.9%; hazard ratio, 0.74 [95% CI, 0.52-1.05]; PInt=0.90). Similarly, the effect of DCB on outcomes in the recurrent events analysis was not influenced by baseline renal function. CONCLUSIONS: Among patients undergoing intervention for in-stent restenosis, the benefit of DCB versus balloon angioplasty was consistent irrespective of baseline CKD status. Baseline renal function also did not influence outcomes in the recurrent event analysis. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04647253.

Auteurs: Behnam N Tehrani, Ilan Vavilin, Richard Shlofmitz, Jeffrey Moses, William Bachinsky, Suhail Dohad, Steven Rudick, Robert Stoler, Brian K Jefferson, William Nicholson, John Altman, Cinthia Bateman, Jennifer A Tremmel, J Dawn Abbott, Wayne Batchelor, Rafael Cavalcante, Robert W Yeh, Ajay J Kirtane

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Bron: Circulation. Cardiovascular interventions, https://doi.org/10.1161/CIRCINTERVENTIONS.126.016978. Bijgewerkt 2026-09-18T01:14:50Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.