الفهرس 
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Abstract
In-stent restenosis (ISR) is defined as the gradual narrowing of a stented artery lesion as a result of neointimal proliferation .
Restenosis or re-occlusion after femoro-popliteal endovascular intervention (ballon dilatation or stent implantation) is the main limitation of endovascular treatment strategies for peripheral artery disease. Within the last years, DCB shown to be associated with higher patency rates compared to plain balloon angioplasty.
Treatment options for management of ISR are numerous but there is no ideal strategy for its treatment . Currently available algorithms for management are unclear.
In this study a total of 25patients were enrolled in this study were randomized in two groups: (DCBgroup) & (PTAgroup)
In DCB group 3 patients were occluded one had sever infection and ended by major amputation, stent –in- stent was used and in two cases.
In PTA group 9 patients were occluded in 2 patients femoropopliteal bypass was done ,3 cases major amputation due to sever uncontrollable infection and in 2 patients DCB treatment and follow up as he was claudicant.and in 2 patients claudication and follow up were done .
Target lesion revascularization(TLR) was reported inDCB group 3/11 patients(27.27%) in 2 patient stent in stent was used and in the other bellow knee amputation was done due to poor distal run off. In PTA group it was recorded 9/14(64.28%)in 2 cases femoropopliteal bypass were done one of them needed major amputation, in other 3 case DCB was used ,in 2 cases stent in stent treatement and in 2 cases below knee amputation were done due to ascending infection in one case and poor distal run off in the other case.(total number of major amputaion in PTA cases were 3 )
As regard limb salvage it was 90.9%in DCB group(10/11 patients) while in PTA group it was 87.57%(11/14 patients).
conclusion
Patients underwent DCB showed that DCB was superior to PTA results regarding patency rate,TLR and limb salvage rate.
Recommendations
The limitations of this study including the small sample size, the length of stenosis wasn’t determined, and the follow-up period was only for one year, whereas better findings can be assessed at longer period of follow-up. Another limitation is the distance of walking by patients wasn’t estimated as well as their performance.
Strengths of this study include it is one of the few studies compared between DCB and PTA outcomes in Egypt. The study was simple and the results are easy to understand. The study included prospective and retrospective methods for gathering data.
Further studies including larger sample size are recommended with the assessment of the performance of patients and long-term of follow-up.