Document Detail


Randomized comparison of angioplasty of complex coronary lesions at a single center. Excimer Laser, Rotational Atherectomy, and Balloon Angioplasty Comparison (ERBAC) Study.
MedLine Citation:
PMID:  9236422     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The purpose of this study was to test whether coronary revascularization with ablation of either excimer laser or rotational atherectomy can improve the initial angiographic and clinical outcomes compared with dilatation (balloon angioplasty) alone. METHODS AND RESULTS: At a single center, a total of 685 patients with symptomatic coronary disease warranting elective percutaneous revascularization for a complex lesion were randomly assigned to balloon angioplasty (n = 222), excimer laser angioplasty (n = 232), or rotational atherectomy (n = 231). The primary end point was procedural success (diameter stenosis < 50%, absence of death, Q-wave myocardial infarction, or coronary artery bypass surgery). The patients who underwent rotational atherectomy had a higher rate of procedural success than those who underwent excimer laser angioplasty or conventional balloon angioplasty (89% versus 77% and 80%, P = .0019), but no difference was observed in major in-hospital complications (3.2% versus 4.3% versus 3.1%, P = .71). At the 6-month follow-up, revascularization of the original target lesion was performed more frequently in the rotational atherectomy group (42.4%) and the excimer laser group (46.0%) than in the angioplasty group (31.9%, P = .013). CONCLUSIONS: Procedural success of rotational atherectomy is superior to laser angioplasty and balloon angioplasty; however, it does not result in better late outcomes. The role of plaque debulking before balloon dilatation in percutaneous coronary revascularization remains to be fully defined.
Authors:
N Reifart; M Vandormael; M Krajcar; S Göhring; W Preusler; F Schwarz; H Störger; M Hofmann; J Klöpper; S Müller; J Haase
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Circulation     Volume:  96     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1997 Jul 
Date Detail:
Created Date:  1997-08-14     Completed Date:  1997-08-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  91-8     Citation Subset:  AIM; IM    
Affiliation:
Herzzentrum Frankfurt, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angioplasty, Balloon / methods*
Angioplasty, Transluminal, Percutaneous Coronary
Atherectomy, Coronary / methods*
Coronary Angiography
Coronary Disease / radiography,  therapy*
Female
Follow-Up Studies
Humans
Laser Therapy
Male
Middle Aged
Prospective Studies
Recurrence
Treatment Failure

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


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