| Influence of stenotic lesion morphology on immediate and long-term (6 months) angiographic outcome: comparative analysis of directional coronary atherectomy versus standard balloon angioplasty. | |
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MedLine Citation:
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PMID: 8606263 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: This study sought to determine whether preprocedural lesion morphology differentially affects the outcome of directional coronary atherectomy versus standard balloon angioplasty. BACKGROUND: Despite previous studies (Canadian Coronary Atherectomy Trial [CCAT]/Coronary Angioplasty Verus Excisional Atherectomy Trial [CAVEAT]), directional coronary atherectomy continues to be recommended on the basis of lesion-specific features, although the validity of this approach has never been proved. METHODS: A retrospective, subgroup analysis of the CCAT data base (group average +/- SD) was performed. RESULTS: In the long term (6 months), both procedures were equally successful in the proximal left anterior descending coronary artery (directional atherectomy 0.62 +/- 0.70 mm vs. coronary angioplasty 0.70 +/- 0.72 mm, p = NS), with atherectomy tending to perform best in relatively "simple" lesions (American College of Cardiology/American Heart Association [ACC/AHA] type A: atherectomy 0.57 +/- 0.70 mm vs. angioplasty 0.50 +/- 0.77 mm; ACC/AHA type B1: atherectomy 0.65 +/- 0.68 mm vs. angioplasty 0.60 +/- 0.68 mm) and those with moderate dystrophic calcification (atherectomy 0.79 +/- 0.56 mm vs. angioplasty 0.45 +/- 0.73 mm). Although greatest minimal lumen diameter gains were seen in larger (> 3 mm) coronary arteries (atherectomy 0.76 +/- 0.62 mm vs angioplasty 0.80 +/- 0.72 mm, p = NS) and those with severe obstruction (preprocedural minimal lumen diameter < 1.0 mm: atherectomy 0.80 +/- 0.62 mm vs. angioplasty 0.84 +/- 0.63 mm, p = NS), neither technique was superior, and eccentric stenoses (symmetry index < 0.5) had similar outcomes (atherectomy 0.59 +/- 0.49 mm vs. angioplasty 0.62 +/- 0.65 mm, p = NS). CONCLUSIONS: These data refute many preconceptions regarding the choice of directional coronary atherectomy on the basis of anatomic criteria. |
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Authors:
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B P Kimball; E A Cohen; A G Adelman |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 27 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 1996 Mar |
Date Detail:
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Created Date: 1996-05-22 Completed Date: 1996-05-22 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 543-51 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, Toronto and Mount Sinai Hospitals, Toronto, Ontario, Canada. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Angioplasty, Transluminal, Percutaneous Coronary* Atherectomy, Coronary* Coronary Angiography Coronary Disease / pathology*, radiography, therapy* Female Humans Male Middle Aged Retrospective Studies Severity of Illness Index Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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