{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T20:43:35Z","timestamp":1793133815763,"version":"4.5.0"},"reference-count":47,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Despite advances in percutaneous coronary procedures, in-stent restenosis remains a significant challenge. Although sirolimus- and paclitaxel-coated balloons are promising alternatives, their comparative safety and efficacy remain uncertain. PubMed, Embase, and Cochrane databases were searched using relevant keywords from inception until August 2025. A total of 11 studies (7 randomized controlled trials and 4 observational cohort studies) were included, comprising 3633 participants overall. The primary outcomes assessed were target lesion revascularization and target lesion failure. Meanwhile, the Secondary outcomes included stent thrombosis, all-cause mortality, myocardial infarction, major adverse cardiovascular events, survival, binary restenosis, and angiographic endpoints (acute gain, diameter stenosis, in-segment late lumen loss, in-lesion late lumen loss, and in-segment minimal lumen diameter). Interstudy heterogeneity was assessed using\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      \u00b2 and\n                      <jats:italic toggle=\"yes\">X<\/jats:italic>\n                      \u00b2 statistics (\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      \u00b2&gt;50% = significant heterogeneity). Interstudy heterogeneity was low for most outcomes, including all primary clinical endpoints, with moderate heterogeneity observed only for select angiographic measures (notably in-segment late lumen loss and diameter stenosis). Statistical analysis was conducted using R software and RStudio (version 4.4.2), with a\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      value of &lt; 0.05 indicating statistical significance. This meta-analysis examined studies that compared paclitaxel-coated balloon (PCB) versus standard balloon [sirolimus-coated balloon (SCB)] angioplasty. Regarding primary outcomes, there were no notable variations in target lesion failure [risk ratio (RR), 1.08, 95% CI, 0.90\u20131.29,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.36] or target lesion revascularization (RR, 1.16, 95% CI, 0.98\u20131.37,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.08). With all aggregated estimates being nonsignificant, secondary outcomes such as stent thrombosis, all-cause mortality, myocardial infarction, major adverse cardiovascular events, and survival were similar between groups. Angiographic endpoints revealed no discernible variations in late lumen loss (in-lesion and in-segment), acute gain, or diameter stenosis. Nonetheless, the SCB group\u2019s minimal lumen diameter was significantly smaller than that of the PCB group (MD, \u22120.08\u2009mm, 95% CI, \u22120.14 to \u22120.01,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.02). In treating coronary in-stent restenosis, SCB and PCBs show similar overall safety and effectiveness; lesion-specific angiographic variations indicate that customized selection may improve patient outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/hpc.0000000000000415","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T20:00:11Z","timestamp":1768420811000},"page":"e0415","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Sirolimus-Coated Versus Paclitaxel-Coated Balloons for Coronary Artery Disease: A Grade Assessed Systematic Review and Meta-Analysis"],"prefix":"10.1097","volume":"25","author":[{"given":"Fatima","family":"Sajjad","sequence":"first","affiliation":[{"name":"Department of Medicine, Khyber Medical College, Peshawar, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asad Iqbal","family":"Khattak","sequence":"additional","affiliation":[{"name":"Department of Medicine, Bacha Khan Medical College, Mardan, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanza","family":"Farhan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Sindh Medical College, Jinnah Sindh Medical University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayesha","family":"Arshad","sequence":"additional","affiliation":[{"name":"Department of Medicine, Dow Medical College (Department of Public Health), Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Afridi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Khyber Medical College, Peshawar, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Abdullah","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Medicine, Khyber Medical College, Peshawar, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iqra","family":"Shahid","sequence":"additional","affiliation":[{"name":"Department of Medicine, King Edward Medical University, Mayo Hospital, Lahore, Punjab, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeeshan","family":"Imtiaz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Mayo Clinic, Rochester, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hammad","family":"Naveed","sequence":"additional","affiliation":[{"name":"Department of Medicine, King Edward Medical University, Lahore, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umama","family":"Alam","sequence":"additional","affiliation":[{"name":"Department of Medicine, Khyber Medical College, Peshawar, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fathimathul","family":"Henna","sequence":"additional","affiliation":[{"name":"Department of Medicine, Dubai Medical College for Girls, Dubai, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoya","family":"Riaz","sequence":"additional","affiliation":[{"name":"Department of Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fazia","family":"Khattak","sequence":"additional","affiliation":[{"name":"Department of Medicine, Khyber Medical College, Peshawar, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saad Ahmed","family":"Waqas","sequence":"additional","affiliation":[{"name":"Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raheel","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Medicine, Academic Clinical Lecturer, Newcastle University, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"R1-20260522","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1093\/eurheartj\/ehu383","article-title":"Prognostic role of restenosis in 10,004 patients undergoing routine control angiography after coronary stenting.","volume":"36","author":"Cassese","year":"2015","journal-title":"Eur Heart J"},{"key":"R2-20260522","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/S0140-6736(15)60657-2","article-title":"Percutaneous coronary interventional strategies for treatment of in-stent restenosis: a network 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