| The role of acute wall recoil and late restenosis: results of the OCBAS trial (Optimal Coronary Balloon Angioplasty with Provisional Stenting versus Primary Stent). | |
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MedLine Citation:
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PMID: 12036479 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Early deterioration of minimal luminal diameter immediately after PTCA, has been associated with an increase of late restenosis. Lesions with no early loss after PTCA have a low restenosis rate. Coronary stents reduce restenosis in lesions exhibiting early wall recoil. The purpose of the OCBAS study was to compare two strategies during coronary interventions; provision vs. elective stenting. 116 patients with good PTCA results were randomized to stent (n = 57) or to optimal PTCA (n = 59). After randomization in PTCA group, 13.5% of the patients crossed over to stent due to early loss (provisional stenting). Baseline demographic and angiographic characteristics were similar in both groups of patients. At 7.6 months, 96.6% of the entire population had a follow-up angiographic study; 98.2% in the stent and 94.9% in the PTCA group. Immediate and follow-up angiographic data showed that acute gain was significantly higher in the stent than in the PTCA group (1.95 vs. 1.5 mm; P < 0.03). However, late loss was significantly higher in the stent than the PTCA groups (0.63 +/- 0.59 vs. 0.26 +/- 0.44, respectively; P = 0.01). Hence, net gain with both techniques was similar (1.32 +/- 0.3 vs. 1.24 +/- 0.29 mm for the stent and PTCA groups respectively; P = NS). Angiographic restenosis rate at follow-up (19.2% in stent vs. 16.4% in PTCA; P = NS) and TVR (17.5 in stent vs. 13.5% in PTCA; P = NS) were also similar. Furthermore, event-free survival was 80.8% in the stent versus 83.1% in the PTCA group (P = NS). Overall costs (hospital and follow-up) were US$591,740 in the stent versus US$398,480 in the PTCA group (P < 0.02). The strategy of the PTCA with delay angiogram and provisional stent if early loss occurs, had similar restenosis rate and TVR than universal use of bare stents. |
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Authors:
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Alfredo E Rodríguez |
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Publication Detail:
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Type: JOURNAL ARTICLE |
Journal Detail:
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Title: International journal of cardiovascular interventions Volume: 4 ISSN: 1462-8848 ISO Abbreviation: Int J Cardiovasc Intervent Publication Date: 2001 Jun |
Date Detail:
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Created Date: 2002-May-30 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9815622 Medline TA: Int J Cardiovasc Intervent Country: - |
Other Details:
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Languages: ENG Pagination: 99-106 Citation Subset: - |
Affiliation:
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Interventional Cardiology Department, Otamendi Hospital, Buenos Aires, Argentina. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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