Document Detail


Clinical success, complications and restenosis rates with excimer laser coronary angioplasty. The Percutaneous Excimer Laser Coronary Angioplasty Registry.
MedLine Citation:
PMID:  1466319     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The role of excimer laser angioplasty in treating complex coronary artery disease remains uncertain. A randomized trial comparing this new technology with balloon angioplasty cannot be designed until systematic analysis identifies the lesion types that are likely to benefit from treatment with excimer laser angioplasty. In a cohort of 764 patients who had 858 coronary stenoses treated with excimer laser-facilitated angioplasty, relative risk analysis was used to examine acute success, complications and restenosis rates, and the results were compared with those of balloon angioplasty to identify the lesion types that show the greatest benefit with the new treatment. Clinical success was achieved in 657 patients (86%), as indicated by < or = 50% residual stenosis and no in-hospital complication. A major in-hospital complication (death, bypass surgery, or Q-wave or non-Q-wave myocardial infarction) occurred in 58 patients (7.6%). Follow-up angiography was obtained in 70% of eligible patients. Combining angiographic and noninvasive restenosis rates yielded an overall restenosis rate of 46%. Relative risk analysis showed that major complications occurred frequently in lesions at an arterial bifurcation (odds ratio [OR] 5.96 [2.76, 12.6]; p = 0.001). However, certain complex lesions that are difficult to treat with balloon angioplasty (saphenous vein graft lesions, lesions > 10 mm, ostial lesions, calcified stenoses, total occlusions and unsuccessful balloon dilatations), analyzed together as a group, had lower complication rates by univariate (OR 0.59 [0.35, 1.00]; p = 0.051) and multivariate logistic regression (p = 0.006) analyses.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
J A Bittl; T A Sanborn; J E Tcheng; R M Siegel; S G Ellis
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study    
Journal Detail:
Title:  The American journal of cardiology     Volume:  70     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1992 Dec 
Date Detail:
Created Date:  1993-01-21     Completed Date:  1993-01-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1533-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Brigham & Women's Hospital, Boston, Massachusetts 02115.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Laser* / adverse effects
Angioplasty, Transluminal, Percutaneous Coronary
Cohort Studies
Coronary Disease / epidemiology,  surgery*
Female
Graft Occlusion, Vascular / surgery
Humans
Male
Middle Aged
Postoperative Complications / epidemiology
Recurrence
Regression Analysis
Risk Factors
Treatment Outcome
Comments/Corrections
Comment In:
Am J Cardiol. 1992 Dec 15;70(20):1605-6   [PMID:  1466331 ]
Am J Cardiol. 1993 Aug 1;72(3):372   [PMID:  8342527 ]

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


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