TY - JOUR
T1 - Clinical events following excimer laser angioplasty or balloon angioplasty for complex coronary lesions
T2 - Subanalysis of a randomised trial
AU - Appelman, Yolande E.A.
AU - Piek, Jan J.
AU - Redekop, William K.
AU - De Feyter, Pim J.
AU - Koolen, Jacques J.
AU - David, George K.
AU - Strikwerda, Sipke
AU - Tijssen, Jan G.P.
AU - Serruys, Patrick W.
AU - Swijndregt, E. V.
AU - Van Gemert, Martin J.C.
AU - Lie, Kong I.
N1 - t/m 1995 input. ©1997 BMJ Publishing Group
PY - 1998
Y1 - 1998
N2 - Objectives - To compare clinical outcome in patients with complex coronary lesions treated with either excimer laser coronary angioplasty (ELCA) or balloon angioplasty. Patients and design - 308 patients with stable angina and a coronary lesion of more than 10 mm in length were randomised to ELCA (151 patients, 158 lesions) or balloon angioplasty (157 patients, 167 lesions). The primary clinical end points were death, myocardial infarction, coronary bypass surgery, or repeated coronary angioplasty of the randomised segment during six months of follow up. Subanalysis was performed to identify a subgroup of patients with a beneficial clinical outcome following ELCA or balloon angioplasty. Setting - Two university hospitals and one general hospital. Results - There were no deaths. Myocardial infarction, coronary bypass surgery, and repeated angioplasty occurred in 4.6, 10.6, and 21.2%, respectively, of patients treated with ELCA compared with 5.7, 10.8, and 18.5%, respectively, of those treated with balloon angioplasty. ELCA did not yield a favourable clinical outcome in subgroups of patients with long (more than 20 mm) coronary lesions, calcified lesions, small diseased vessels (→2.5 mm reference diameter), or total coronary occlusions. There was a worse clinical outcome in patients with tandem lesions treated with ELCA compared with balloon angioplasty (9/18 v 3/26 lesions; p = 0.01); while a trend towards an unfavourable clinical outcome was found in patients with vessels with a reference diameter of more than 2.5 mm (23166 v 13/63 lesions, p = 0.07) and left circumflex coronary lesions (12/41 v 6/42 lesions, p = 0.08). Conclusions - The findings indicate a worse clinical outcome in patients with lesions of more than 10 mm treated with ELCA compared with balloon angioplasty who have tandem coronary lesions and in those with vessels with a reference diameter of more than 2.5 mm and left circumflex coronary lesions.
AB - Objectives - To compare clinical outcome in patients with complex coronary lesions treated with either excimer laser coronary angioplasty (ELCA) or balloon angioplasty. Patients and design - 308 patients with stable angina and a coronary lesion of more than 10 mm in length were randomised to ELCA (151 patients, 158 lesions) or balloon angioplasty (157 patients, 167 lesions). The primary clinical end points were death, myocardial infarction, coronary bypass surgery, or repeated coronary angioplasty of the randomised segment during six months of follow up. Subanalysis was performed to identify a subgroup of patients with a beneficial clinical outcome following ELCA or balloon angioplasty. Setting - Two university hospitals and one general hospital. Results - There were no deaths. Myocardial infarction, coronary bypass surgery, and repeated angioplasty occurred in 4.6, 10.6, and 21.2%, respectively, of patients treated with ELCA compared with 5.7, 10.8, and 18.5%, respectively, of those treated with balloon angioplasty. ELCA did not yield a favourable clinical outcome in subgroups of patients with long (more than 20 mm) coronary lesions, calcified lesions, small diseased vessels (→2.5 mm reference diameter), or total coronary occlusions. There was a worse clinical outcome in patients with tandem lesions treated with ELCA compared with balloon angioplasty (9/18 v 3/26 lesions; p = 0.01); while a trend towards an unfavourable clinical outcome was found in patients with vessels with a reference diameter of more than 2.5 mm (23166 v 13/63 lesions, p = 0.07) and left circumflex coronary lesions (12/41 v 6/42 lesions, p = 0.08). Conclusions - The findings indicate a worse clinical outcome in patients with lesions of more than 10 mm treated with ELCA compared with balloon angioplasty who have tandem coronary lesions and in those with vessels with a reference diameter of more than 2.5 mm and left circumflex coronary lesions.
KW - AMC wi-eigen
KW - Balloon angioplasty
KW - Excimer laser angioplasty
KW - Laser assisted balloon angioplasty
KW - Randomised trial
UR - http://www.scopus.com/inward/record.url?scp=7144257199&partnerID=8YFLogxK
U2 - https://doi.org/10.1136/hrt.79.1.34
DO - https://doi.org/10.1136/hrt.79.1.34
M3 - Article
C2 - 9505916
SN - 1355-6037
VL - 79
SP - 34
EP - 38
JO - Heart
JF - Heart
IS - 1
ER -