TY - JOUR
T1 - Excimer laser angioplasty versus balloon angioplasty in functional and total coronary occlusions
AU - Appelman, Yolande E.A.
AU - Koolen, Jacques J.
AU - Piek, Jan J.
AU - Redekop, William K.
AU - De Feyter, Pim J.
AU - Strikwerda, Sipke
AU - David, George K.
AU - Serruys, Patrick W.
AU - Tijssen, Jan G.P.
AU - Van Swijndregt, Eline
AU - Lie, Kong I.
AU - van Swijnregt, E.
N1 - Funding Information: From the Departments of Cardiology and Clinical Epidemiology and Biostotistics, Academic Medical Center, Amsterdam; Thoraxcenter, Dijkzigt Hospital, Rotterdam; Catharina Hospital, Eindhoven, the Netherlands. This research was funded by the Dutch Health Insurance Executive Board. Manuscript received December 29, 1995; revised manuscript received and accepted May 2 1, 1996. Address for reprints: Jan J. Pick, MD, Department Academic Medical Center, Meibergdreef 9, B2-108, sterdam, the Netherlands.
PY - 1996
Y1 - 1996
N2 - Registries of excimer laser coronary angioplasty have reported good results in the treatment of complex coronary artery disease, including total or subtotal coronary occlusions. One hundred three patients (103 lesions) with a functional or total coronary occlusion were included in a randomized trial (Amsterdam-Rotterdam [AMRO] trial, total of 308 patients), 49 patients were allocated to laser angioplasty and 54 patients to balloon angioplasty. The primary clinical end points were death, myocardial infarction, coronary bypass surgery, or repeated coronary angioplasty of the randomized segment during a 6-month follow-up period. The primary angiographic end point was the minimal lumen diameter at follow-up in relation to the baseline value (net gain), as determined by an automated contour-detection algorithm. Laser angioplasty was followed by balloon angioplasty in all procedures. The angiographic success rate was 65% in patients treated with excimer laser-assisted balloon angioplasty compared with 61% in patients treated with balloon angioplasty alone. No deaths occurred. There were no significant differences between the laser angioplasty group and the balloon angioplasty group in the incidence of myocardial infarctions (1 patient vs 3, respectively, p = 0.36), coronary bypass surgery (4 patients vs 2, respectively, p = 0.34), repeat angioplasty (10 patients vs 8, respectively, p = 0.46) or primary clinical end point (15 patients vs 12, respectively, p = 0.34). The net gain in minimal lumen diameter and restenosis rate (>50% diameter stenosis at follow-up) were 0.81 ± 0.74 mm and 66.7%, respectively, in patients treated with laser angioplasty compared with 1.04 ± 0.68 mm and 48.5%, respectively, in patients treated with balloon angioplasty (p = 0.59 and p = 0.15, respectively). Excimer laser-assisted balloon angioplasty demonstrated no benefit over balloon angioplasty with respect to initial and long-term clinical and angiographic outcome in the treatment of patients with functional or total coronary occlusions of > 10 mm in length.
AB - Registries of excimer laser coronary angioplasty have reported good results in the treatment of complex coronary artery disease, including total or subtotal coronary occlusions. One hundred three patients (103 lesions) with a functional or total coronary occlusion were included in a randomized trial (Amsterdam-Rotterdam [AMRO] trial, total of 308 patients), 49 patients were allocated to laser angioplasty and 54 patients to balloon angioplasty. The primary clinical end points were death, myocardial infarction, coronary bypass surgery, or repeated coronary angioplasty of the randomized segment during a 6-month follow-up period. The primary angiographic end point was the minimal lumen diameter at follow-up in relation to the baseline value (net gain), as determined by an automated contour-detection algorithm. Laser angioplasty was followed by balloon angioplasty in all procedures. The angiographic success rate was 65% in patients treated with excimer laser-assisted balloon angioplasty compared with 61% in patients treated with balloon angioplasty alone. No deaths occurred. There were no significant differences between the laser angioplasty group and the balloon angioplasty group in the incidence of myocardial infarctions (1 patient vs 3, respectively, p = 0.36), coronary bypass surgery (4 patients vs 2, respectively, p = 0.34), repeat angioplasty (10 patients vs 8, respectively, p = 0.46) or primary clinical end point (15 patients vs 12, respectively, p = 0.34). The net gain in minimal lumen diameter and restenosis rate (>50% diameter stenosis at follow-up) were 0.81 ± 0.74 mm and 66.7%, respectively, in patients treated with laser angioplasty compared with 1.04 ± 0.68 mm and 48.5%, respectively, in patients treated with balloon angioplasty (p = 0.59 and p = 0.15, respectively). Excimer laser-assisted balloon angioplasty demonstrated no benefit over balloon angioplasty with respect to initial and long-term clinical and angiographic outcome in the treatment of patients with functional or total coronary occlusions of > 10 mm in length.
UR - http://www.scopus.com/inward/record.url?scp=10644271889&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/S0002-9149(96)00416-X
DO - https://doi.org/10.1016/S0002-9149(96)00416-X
M3 - Article
C2 - 8857478
SN - 0002-9149
VL - 78
SP - 757
EP - 762
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 7
ER -