| Comparison of effectiveness of excimer laser angioplasty in patients with acute coronary syndromes in those with versus those without normal left ventricular function. | |
| | |
MedLine Citation:
|
PMID: 12667563 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Depressed left ventricular (LV) ejection fraction (EF) adversely affects procedural outcome during percutaneous coronary revascularization. This study examined the acute results, effectiveness, and safety of excimer laser coronary angioplasty (ELCA) in patients with acute coronary ischemic syndromes whose LVEF was depressed (<40%) versus those with preserved LVEF. One hundred patients with acute coronary syndromes (51 with unstable angina and 49 with acute myocardial infarction) underwent ELCA. Twenty-five patients (group 1) (29 lesions; 72% thrombotic) had decreased LVEF (mean 28 +/- 6%) and 75 patients (group 2) (81 lesions; 60% thrombotic) had preserved LVEF (mean 53 +/- 8%). Group 1 had a higher incidence of 3-vessel disease, Q-wave acute myocardial infarction, cardiogenic shock, diabetes, and hypertension. High laser success (87% group 1 vs 93% group 2, p = NS) and procedural success (93% group 1 vs 98% group 2, p = NS) were achieved in both groups. Minimal luminal diameter in group 1 increased from 0.7 +/- 0.5 to 1.4 +/- 0.5 mm after the laser procedure and finally to 3.0 +/- 0.4 mm; in group 2, minimal luminal diameter increased from 0.7 +/- 0.4 to 1.3 +/- 0.5 mm after the procedure to a final of 3.0 +/- 0.5 mm. The laser energy vaporized 75% of thrombus burden from the target lesion in group 1 versus 79% in group 2 (p = NS). Thrombolysis In Myocardial Infarction flow in group 1 increased from 1.4 +/- 1.2 to 2.7 +/- 0.7 by laser and finally to 2.9 +/- 0.3, and in group 2 from 2.0 +/- 1.0 to 2.8 +/- 0.6 after the laser procedure to a final of 2.9 +/- 0.4. There were no deaths, emergency bypass surgeries, strokes, or acute vessel closures in either group. Thus, ELCA is a safe and feasible revascularization modality for patients with acute coronary syndromes whose LVEF is depressed. The laser energy vaporizes a large thrombus burden from the treated plaque. Angiographic intracoronary thrombus does not adversely affect device and procedural success in these select patients. |
| | |
Authors:
|
On Topaz; Anthony J Minisi; Nelson Bernardo; Ramin Alimar; Alma Ereso; Rakesh Shah |
Related Documents
:
|
10822073 - Antithrombotic treatment (argatroban vs. heparin) in coronary angioplasty in angina pec... 2965593 - Ten year follow up of patients with single vessel coronary artery disease that was suit... 11121593 - Effects of hmg-coa reductase inhibitor on hemostasis. |
Publication Detail:
|
Type: Comparative Study; Journal Article |
Journal Detail:
|
Title: The American journal of cardiology Volume: 91 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2003 Apr |
Date Detail:
|
Created Date: 2003-04-01 Completed Date: 2003-05-06 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: 797-802 Citation Subset: AIM; IM |
Affiliation:
|
Cardiac Catheterization Laboratories, Division of Cardiology, Medical College of Virginia Hospitals, Medical College of Virginia, Virginia Commonwealth University, Richmond 23249, USA. ontopaz@aol.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Acute Disease Aged Angioplasty, Balloon, Laser-Assisted* Angioplasty, Transluminal, Percutaneous Coronary* Blood Vessel Prosthesis Implantation Coronary Disease / complications, physiopathology*, therapy* Female Humans Incidence Male Middle Aged Postoperative Complications / etiology, physiopathology Stents Stroke Volume / physiology Syndrome Treatment Outcome Ventricular Function, Left / physiology* Virginia / epidemiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Comparison of outcomes (early and six- month) of direct stenting with conventional stenting (a meta-...
Next Document: Bleeding risk of platelet glycoprotein IIb/IIIa receptor antagonists in broad-based practice (result...