{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T19:35:17Z","timestamp":1789760117938,"version":"4.0.1"},"reference-count":38,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>We sought to investigated the outcomes of patients with chronic kidney disease (CKD) and drug-eluting stent (DES)-in-stent restenosis (ISR) undergoing percutaneous coronary intervention (PCI) with a drug-coated balloon (DCB) or thin strut drug-eluting stent (thin-DES). Consecutive patients with DES-ISR who underwent PCI with a thin-DES or a paclitaxel-coated DCB for DES-ISR were enrolled. The primary outcome was target lesion revascularization (TLR), while the secondary was target vessel revascularization (TVR) and device-oriented composite endpoint (DOCE). The pooled analysis included 1,317 patients, with 585 (44.42%) treated using a thin-DES and 732 (55.58%) by DCB. In the crude analysis of CKD patients (n\u2009=\u2009286) undergoing PCI for ISR, thin-DES vs. DCB showed similar outcomes for TLR (hazard ratio [HR]=0.94, 95% confidence interval [CI]=0.44\u20132.00; p\u2009=\u20090.873), TVR (HR\u2009=\u20090.82, 95% CI\u2009=\u20090.44\u20131.55; p\u2009=\u20090.542), MI (HR\u2009=\u20090.71, 95% CI\u2009=\u20090.34\u20131.46; p\u2009=\u20090.348) and DOCE (HR\u2009=\u20090.71, 95% CI\u2009=\u20090.36\u20131.40; p\u2009=\u20090.325). After propensity score matching (n\u2009=\u2009184), the HRs remained non-significant for TLR (0.52, 95% CI\u2009=\u20090.21\u20131.29; p\u2009=\u20090.159), TVR (0.54, 95% CI\u2009=\u20090.24\u20131.01; p\u2009=\u20090.134), MI (0.56, 95% CI\u2009=\u20090.24\u20131.32; p\u2009=\u20090.183), TV-MI (0.56, 95% CI\u2009=\u20090.09\u20133.39; p\u2009=\u20090.528), cardiac death (0.63, 95% CI\u2009=\u20090.10\u20133.81; p\u2009=\u20090.615), and DOCE (0.45, 95% CI\u2009=\u20090.19\u20131.04; p\u2009=\u20090.062). In conclusion, in CKD patients undergoing PCI for ISR, thin\u2010DES treatment was associated with a numerical reduction in TLR, TVR, and DOCE compared with DCB. However, these differences did not achieve statistical significance in the crude or propensity score-matched analyses.<\/jats:p>","DOI":"10.1371\/journal.pone.0337991","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T18:34:07Z","timestamp":1767033247000},"page":"e0337991","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Long-term outcomes following drug-coated balloons versus thin-strut drug-eluting stents for treatment of in-stent restenosis in Chronic Kidney Disease (CKD 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