Alfonso, FernandoPérez-Vizcayno, María JoséGarcía Del Blanco, BrunoOtaegui, ImanolMasotti, MónicaZueco, JavierVeláquez, MaiteSanchís, JuanGarcía-Touchard, ArturoLázaro-García, RosaMoreu, JoséBethencourt, ArmandoCuesta, JavierRivero, FernandoCárdenas, AlbertoGonzalo, NievesJiménez-Quevedo, PilarFernández, CristinaRIBS V Study Investigators2023-01-252023-01-252016-06-20http://hdl.handle.net/10668/10211The aim of this study was to compare the long-term efficacy of everolimus-eluting stents (EES) and drug-eluting balloons (DEB) in patients with bare-metal stent in-stent restenosis (ISR). The relative long-term clinical efficacy of current therapeutic modalities in patients with ISR remains unknown. The 3-year clinical follow-up (pre-specified endpoint) of patients included in the RIBS V (Restenosis Intra-Stent of Bare-Metal Stents: Drug-Eluting Balloon vs Everolimus-Eluting Stent Implantation) randomized clinical trial was analyzed. All patients were followed yearly using a pre-defined structured questionnaire. A total of 189 patients with bare-metal stent ISR were allocated to either EES (n = 94) or DEB (n = 95). Clinical follow-up at 1, 2, and 3 years was obtained in all patients (100%). Compared with patients treated with DEB, those treated with EES obtained better angiographic results, including larger minimal luminal diameter at follow-up (primary study endpoint; 2.36 ± 0.6 mm vs. 2.01 ± 0.6 mm; p 1 year) target vessel (3 [3.2%] vs. 3 [3.2%]; p = 0.95) and target lesion (1 [1%] vs. 2 [2.1%]; p = 0.54) revascularization was low and similar in the 2 arms. Rates of definite or probable stent thrombosis (1% vs. 0%) were also similar in the 2 arms. The 3-year clinical follow-up of the RIBS V clinical trial confirms the sustained safety and efficacy of EES and DEB in patients treated for bare-metal stent ISR. In this setting, EES reduce the need for target lesion revascularization at very long-term follow-up. (RIBS V [Restenosis Intra-Stent of Bare Metal Stents: Paclitaxel-Eluting Balloon vs Everolimus-Eluting Stent] [RIBS V]; NCT01239953).endrug-eluting balloon(s)drug-eluting stent(s)everolimus-eluting stent(s)in-stent restenosisAgedAngioplasty, Balloon, CoronaryCardiac CathetersCardiovascular AgentsCoated Materials, BiocompatibleCoronary AngiographyCoronary DiseaseCoronary RestenosisDrug-Eluting StentsEverolimusFemaleHumansMaleMetalsMiddle AgedPaclitaxelPercutaneous Coronary InterventionProspective StudiesProsthesis DesignRisk FactorsSpainStentsSurveys and QuestionnairesTime FactorsTreatment Outcomeresearch article27339840open access10.1016/j.jcin.2016.03.0371876-7605https://doi.org/10.1016/j.jcin.2016.03.037