Document Detail


Analysis of late lumen narrowing after excimer laser-facilitated coronary angioplasty.
MedLine Citation:
PMID:  8176088     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this study was to analyze the quantitative angiographic factors affecting restenosis after excimer laser-facilitated coronary angioplasty. BACKGROUND: Restenosis after balloon angioplasty, directional atherectomy and coronary stenting has been analyzed using both dichotomous (> or = 50% diameter stenosis) and continuous (late lumen narrowing) end points, leading to the conclusion that achieving a large lumen diameter at the time of the procedure is associated with a lower risk of angiographic restenosis. METHODS: Quantitative angiographic measurements were made before treatment, after laser angioplasty, after adjunctive balloon angioplasty and at 6-month angiographic follow-up in 168 patients with 179 treated lesions. RESULTS: The immediate increase in lumen diameter (total acute gain 1.45 +/- 0.71 mm [mean +/- SD]) was due to the combination of laser treatment (0.79 +/- 0.61 mm) and subsequent adjunctive balloon angioplasty (0.66 +/- 0.55 mm). At follow-up, the minimal lumen diameter had decreased (late loss 0.71 +/- 0.84 mm), yielding an overall restenosis rate of 50% (defined dichotomously by > or = 50% diameter stenosis). Multivariable regression analyses showed that restenosis was related to vessel diameter, as well as minimal lumen diameter, achieved immediately after the procedure. CONCLUSIONS: Although the restenosis rates for the small vessels typically treated with excimer laser angioplasty were high, the lowest restenosis rates were seen in large vessels with the largest postprocedural minimal lumen diameters. The goal of this procedure should be to safely achieve the largest lumen possible with the combination of laser treatment and adjunctive balloon dilation.
Authors:
J A Bittl; R E Kuntz; P Estella; T A Sanborn; D S Baim
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  23     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1994 May 
Date Detail:
Created Date:  1994-06-06     Completed Date:  1994-06-06     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1314-20     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon, Laser-Assisted* / statistics & numerical data
Angioplasty, Transluminal, Percutaneous Coronary* / statistics & numerical data
Boston / epidemiology
Coronary Angiography / statistics & numerical data
Coronary Disease / epidemiology*,  radiography,  surgery
Female
Follow-Up Studies
Humans
Linear Models
Logistic Models
Male
Middle Aged
New York City / epidemiology
Prognosis
Recurrence
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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