Heart 1998;79:34-38 ( January )
Clinical events following excimer laser angioplasty or balloon angioplasty for complex coronary lesions: subanalysis of a randomised trial
a Department of Cardiology, Academic Medical
Center, University of Amsterdam, Netherlands, b Department
of Clinical Epidemiology and Biostatistics, Academic Medical Center,
University of Amsterdam, c Laser Center, Academic Medical Center, University of Amsterdam, d Department of Cardiology,
Thorax Center, Dijkzigt Hospital, Rotterdam, Netherlands, e Department of Cardiology, Catharina Hospital, Eindhoven,
Netherlands
Correspondence to: Dr Piek, Department of Cardiology B2-108, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands.
Accepted for publication 22 September 1997
Objectives
To compare clinical outcome in patients
with complex coronary lesions treated with either excimer laser
coronary angioplasty (ELCA) or balloon angioplasty.
Patients and design308 patients with stable
angina and a coronary lesion of more than 10 mm in length were
randomised to ELCA (151 patients, 158 lesions) or balloon angioplasty
(157 patients, 167 lesions). The primary clinical end points were
death, myocardial infarction, coronary bypass surgery, or repeated
coronary angioplasty of the randomised segment during six months of
follow up. Subanalysis was performed to identify a subgroup of patients
with a beneficial clinical outcome following ELCA or balloon angioplasty.
SettingTwo university hospitals and one general hospital.
ResultsThere were no deaths. Myocardial
infarction, coronary bypass surgery, and repeated angioplasty occurred
in 4.6, 10.6, and 21.2%, respectively, of patients treated with ELCA
compared with 5.7, 10.8, and 18.5%, respectively, of those treated
with balloon angioplasty. ELCA did not yield a favourable clinical
outcome in subgroups of patients with long (more than 20 mm) coronary lesions, calcified lesions, small diseased vessels (
2.5 mm
reference diameter), or total coronary occlusions. There was a worse
clinical outcome in patients with tandem lesions treated with ELCA
compared with balloon angioplasty (9/18 v 3/26 lesions;
p = 0.01); while a trend towards an unfavourable clinical outcome was
found in patients with vessels with a reference diameter of more than
2.5 mm (23/66 v 13/63 lesions, p = 0.07) and left
circumflex coronary lesions (12/41 v 6/42 lesions,
p = 0.08).
ConclusionsThe findings indicate a worse clinical
outcome in patients with lesions of more than 10 mm treated with ELCA
compared with balloon angioplasty who have tandem coronary lesions and
in those with vessels with a reference diameter of more than 2.5 mm
and left circumflex coronary lesions.
© 1998 by Heart
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
-
Drugs: cardiovascular system
-
Interventional cardiology
-
Clinical diagnostic tests
- Acute coronary syndromes
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
