Document Detail


Percutaneous transmyocardial laser revascularization: overview of US clinical trials.
MedLine Citation:
PMID:  10867767     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Data from four surgical trials of laser transmyocardial revascularization (TMR) show pain reductions of at least two classes occurred among 25-76% of patients, significantly greater than with optimal medical therapy. The safety and feasibility of percutaneous TMR (PTMR) was proved in multiple uncontrolled registry studies. With PTMR in two randomized trials enrolling about 550 patients, improvements were found among 45% and 66% of patients as compared with 13% for best medical therapy. Other encouraging observations included significant improvements in exercise time (85 and 100 seconds) as compared with minimal or negative results for medical therapy, consistent overall exercise time improvements for PTMR, and overall patient perceptions of anginal stability and global health. Peri-procedural mortality is low and ranged from 0% to 0.6%. Some skepticism remains about the procedures, arising from failure in most cases to show improvements with SPECT imaging and lack of conclusive insights into the mechanism of action. A randomized 'blinded' study is underway to establish a definitive therapeutic value for catheter-based TMR. Nonetheless, preliminary clinical data seem promising for catheter-based TMR for obtaining symptomatic improvement in patients with chronic refractory ischemic coronary syndromes.
Authors:
R Kornowski; S Fuchs; M B Leon
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Seminars in interventional cardiology : SIIC     Volume:  5     ISSN:  1084-2764     ISO Abbreviation:  Semin Interv Cardiol     Publication Date:  2000 Jun 
Date Detail:
Created Date:  2000-09-07     Completed Date:  2000-09-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9606070     Medline TA:  Semin Interv Cardiol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  97-101     Citation Subset:  IM    
Copyright Information:
Copyright 2000 Harcourt Publishers Ltd.
Affiliation:
The Cardiac Catheterization Laboratory and Cardiovascular Research Institute, Washington Hospital Center, Washington, DC 20010, USA. rxk3@mhg.edu
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MeSH Terms
Descriptor/Qualifier:
Angina Pectoris / surgery
Coronary Disease / surgery*
Heart Catheterization
Humans
Laser Therapy* / methods
Myocardial Revascularization / instrumentation,  methods*
Randomized Controlled Trials as Topic
United States

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


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