| Evaluation of the long-term functional outcome assessed by myocardial perfusion scintigraphy following excimer laser angioplasty compared to balloon angioplasty in longer coronary lesions. | |
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MedLine Citation:
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PMID: 11219598 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Evaluation of the long-term functional outcome assessed by exercise myocardial perfusion imaging following excimer laser angioplasty compared to balloon angioplasty in coronary lesions > 10 mm in length. BACKGROUND: Previous randomized studies evaluating the effect of coronary interventions mainly focused on the long-term clinical and angiographic outcome. The functional outcome, assessed by myocardial perfusion scintigraphy, has not been evaluated in a randomized setting. METHODS: A total of 308 patients with stable angina and a longer coronary lesion (> 10 mm) were randomized to excimer laser angioplasty or balloon angioplasty. A 99mTechnetium-2-methoxy isobutyl isonitrile (MIBI) single-photon emission computed tomography (SPECT) study was performed in 139 patients before the initial angioplasty procedure and at 6 months follow-up (73 patients in the laser group versus 66 patients in the balloon group, respectively). Exercise tolerance at follow-up was compared to baseline values by means of exercise duration and double product at peak exercise. Myocardial perfusion of the randomized vascular bed was assessed semi-quantitatively on the MIBI SPECT images. The reversible defects were graded as mild, moderate or severe. Myocardial perfusion at follow-up was expressed as a percentage reduction in incidence and grading of the reversible defects compared to baseline values. RESULTS: Forty-four (61%) patients assigned to laser angioplasty were asymptomatic at 6 months follow-up compared to 34 (52%) patients assigned to balloon angioplasty (p = NS). Improvement in exercise duration and double product were 0.7 +/- 2.1 min and 4.3 +/- 6.2 min/mmHg/l,000, respectively, in the laser group, versus 0.3 +/- 2.5 min and 3.1 +/- 5.5 min/mmHg/1,000, respectively, in the balloon group (both p = NS). The percentage reduction of reversible defects was 23% in patients assigned to laser angioplasty vs. 29% in patients assigned to balloon angioplasty (Relative risk [RR]: 0.79, 95% confidence interval [CI]: 0.40-1.57; p = 0.50). The mild, moderate and severe reversible defects improved in 44.4, 63.6 and 66.6%, respectively, in the laser angioplasty group vs. 66.6, 53.8 and 90%, respectively, in the balloon angioplasty group. None of the comparisons were significantly different. CONCLUSION: Excimer laser angioplasty compared to balloon angioplasty in coronary lesions > 10 mm in length yields a similar long-term functional outcome assessed by anginal status, exercise tolerance and myocardial perfusion. |
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Authors:
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Y E Appelman; J J Piek; E E van der Wall; W K Redekop; E A van Royen; P M Fioretti; P J de Feyter; J J Koolen; S Strikwerda; P W Serruys; G K David; J G Tijssen; K I Lie |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: International journal of cardiac imaging Volume: 16 ISSN: 0167-9899 ISO Abbreviation: Int J Card Imaging Publication Date: 2000 Aug |
Date Detail:
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Created Date: 2001-02-21 Completed Date: 2001-04-26 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8600426 Medline TA: Int J Card Imaging Country: Netherlands |
Other Details:
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Languages: eng Pagination: 267-77 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Clinical Epidemiology and Biostatistics, Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Angina Pectoris / radionuclide imaging, surgery Angioplasty, Balloon, Laser-Assisted / methods* Confidence Intervals Coronary Disease / radionuclide imaging*, surgery* Exercise Test Female Follow-Up Studies Humans Male Middle Aged Reference Values Technetium Tc 99m Sestamibi / diagnostic use Tomography, Emission-Computed, Single-Photon / methods* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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109581-73-9/Technetium Tc 99m Sestamibi |
| Comments/Corrections | |
Comment In:
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Int J Card Imaging. 2000 Aug;16(4):279-82
[PMID:
11219599
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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