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Titolo:
A MULTICENTER, RANDOMIZED TRIAL OF CORONARY ANGIOPLASTY VERSUS DIRECTIONAL ATHERECTOMY FOR PATIENTS WITH SAPHENOUS-VEIN BYPASS GRAFT LESIONS
Autore:
HOLMES DR; TOPOL EJ; CALIFF RM; BERDAN LG; LEYA F; BERGER PB; WHITLOW PL; SAFIAN RD; ADELMAN AG; KELLETT MA; TALLEY JD; SHANI J; GOTTLIEB RS; PINKERTON CA; LEE KL; KEELER GP; ELLIS SG; FRANCO I; DEBOWEY D; LINCOFF M; KEREIAKES D; ABBOTTSMITH C; KENT K; LEON M; PICHARD A; SATLER L; POPMA J; HINOHARA T; KOSINSKI E; SIMONTON C; BERSIN RM; CEDARHOLM J; WILSON B; MCKEEVER LS; MARTIN F; CHAPEKIS A; GEORGE BS; COWLEY M; PINKERTON C; PETERS T; COHEN M; JACOBS A; FAXON DP; LEVINE G; KELLETT M; KING S; MASDEN R; MOONEY M; WHITE CJ; HOFLING B; WILLIAMS D; TALLEY D; WHITE H; BRINKER J; STEWART DK; CHAMBERS J; AU P; PALACIOS I; KUNTZ R; SAFIAN R; IVANHOE R; PUEL J; RAYBUCK B; BONAN R; PEARSON C; LAIRD JR; BURWELL L; CARNEY RJ; BELLINGER R; RICCI D; SPOKOJNY A; MARTYAK TE; COHEN E; ADELMAN A; LEWIS S; WEBB J; TRABOULSI D; REEN B; NIESS G; SLATER J; MARQUIS JF; BUSH HS; MOSES JW; HEUSER R; AYRES M; APFELBAUM MA; BLEICH S; ROUBIN G; STEIN R; HARTMAN CW; DENARDO R; LINDSEY D; CORIN W; UNTERECKER B; STILLABOWER M; MICK M; SHARMA S; COHEN H; BARBEAU G; GRIFFIN J; ARNOLD A; CALIFF R;
Indirizzi:
MAYO CLIN & MAYO FDN,CARDIAC CARE UNIT,200 1ST ST SW ROCHESTER MN 55905 CLEVELAND CLIN FDN CLEVELAND OH 44195 DUKE UNIV,MED CTR DURHAM NC 00000 LOYOLA MED CTR CHICAGO IL 00000 WILLIAM BEAUMONT ROYAL OAK HOSP ROYAL OAK MI 00000 UNIV LOUISVILLE LOUISVILLE KY 40292 MAINE MED CTR PORTLAND ME 04102 MAIMONIDES HOSP BROOKLYN NY 00000 GRAD HOSP PHILADELPHIA PHILADELPHIA PA 19146 TORONTO GEN HOSP TORONTO ON CANADA ST VINCENTS HOSP INDIANAPOLIS IN 00000 CHRIST HOSP CINCINNATI OH 45219 CARDIOL CTR WASHINGTON DC 00000 SEQUOIA HOSP REDWOOD CITY CA 00000 ST VINCENTS MED CTR BRIDGEPORT CT 00000 CAROLINAS MED CTR CHARLOTTE NC 28203 CAROLINAS HEART INST CHARLOTTE NC 28232 MIDWEST HEART RES FDN LOMBARD IL 00000 METHODIST HOSP MEMPHIS TN 00000 RIVERSIDE METHODIST HOSP COLUMBUS OH 43214 VIRGINIA COMMONWEALTH UNIV,MED COLL VIRGINIA RICHMOND VA 23298 ST FRANCIS HOSP BEECH GROVE IN 00000 BOSTON UNIV,MED CTR BOSTON MA 00000 EMORY HOSP ATLANTA GA 00000 JEWISH HOSP LOUISVILLE KY 00000 MINNEAPOLIS HEART INST MINNEAPOLIS MN 00000 OCHSNER FDN HOSP NEW ORLEANS LA 00000 UNIV MUNICH,KLINIKUM GROSSHADERN W-8000 MUNICH GERMANY RHODE ISL HOSP PROVIDENCE RI 02902 SW CARDIOL ASSOCIATES ALBUQUERQUE NM 00000 GRAD CARDIOL CONSULTANTS PHILADELPHIA PA 00000 JOHNS HOPKINS UNIV HOSP BALTIMORE MD 00000 LOYOLA MED CTR MAYWOOD IL 00000 UNIV WASHINGTON SEATTLE WA 98195 MASSACHUSETTS GEN HOSP BOSTON MA 02114 BETH ISRAEL HOSP BOSTON MA 02215 FLORIDA HOSP ORLANDO FL 00000 CHU RANGUEIL F-31054 TOULOUSE FRANCE FAIRFAX HOSP ANNANDALE VA 00000 MONTREAL HEART INST MONTREAL PQ H1T 1C8 CANADA WALTER REED ARMY MED CTR WASHINGTON DC 20307 UNIV VIRGINIA CHARLOTTESVILLE VA 00000 MOTHER FRANCES TYLER TX 00000 SUTTER HOSP SACRAMENTO CA 00000 HAHNEMANN UNIV PHILADELPHIA PA 00000 VANCOUVER GEN HOSP VANCOUVER BC CANADA CORNELL UNIV,MED CTR,NEW YORK HOSP NEW YORK NY 10021 HENRICO HOSP FREDERICKSBURG VA 00000 TORONTO GEN HOSP N YORK ON CANADA MT SINAI HOSP TORONTO ON M5G 1X5 CANADA CARLESTON MED CTR CHARLESTON WV 00000 ST PAULS HOSP VANCOUVER BC V6Z 1Y6 CANADA FOOTHILLS PROV GEN HOSP CALGARY AB CANADA PRESBYTERIAN HOSP CHARLOTTE NC 00000 ST LUKES ROOSEVELT HOSP NEW YORK NY 10025 OTTAWA HEART OTTAWA ON CANADA CLEVELAND CLIN FLORIDA FT LAUDERDALE FL 00000 LENOX HILL HOSP NEW YORK NY 10021 HEALTHWEST REG MED CTR PHOENIX AZ 00000 FT SANDERS REG MED CTR KNOXVILLE TN 00000 COLUMBIA PRESBYTERIAN MED CTR NEW YORK NY 10032 E JEFFERSON HOSP METAIRIE LA 00000 UNIV ALABAMA BIRMINGHAM AL 00000 SENTARA NORFOLK GEN HOSP NORFOLK VA 00000 ST MARYS HOSP SAGINAW MI 00000 SHADYSIDE HOSP PITTSBURGH PA 15232 PRESBYTERIAN MED CTR PHILADELPHIA PA 19104 MED CTR DELAWARE NEWARK DE 00000 METHODIST HOSP INDIANA INDIANAPOLIS IN 46202 MT SINAI MED CTR NEW YORK NY 10029 ST JOHNS HOSP SANTA MONICA CA 00000 LAVAL HOSP ST FOY PQ CANADA VIRGINIA BEACH GEN HOSP VIRGINIA BEACH VA 00000 OLYMPIA FIELDS HOSP 3 OLYMPIA FIELDS IL 00000 MCLAREN REG MED CTR FLINT MI 00000
Titolo Testata:
Circulation
fascicolo: 7, volume: 91, anno: 1995,
pagine: 1966 - 1974
SICI:
0009-7322(1995)91:7<1966:AMRTOC>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
TRANS-LUMINAL ANGIOPLASTY; AORTOCORONARY BYPASS; BALLOON ANGIOPLASTY; FOLLOW-UP; RESTENOSIS; SURGERY; ATHEROSCLEROSIS; EXPERIENCE; STENOSIS; ARTERIES;
Keywords:
ANGIOPLASTY; REVASCULARIZATION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
37
Recensione:
Indirizzi per estratti:
Citazione:
D.R. Holmes et al., "A MULTICENTER, RANDOMIZED TRIAL OF CORONARY ANGIOPLASTY VERSUS DIRECTIONAL ATHERECTOMY FOR PATIENTS WITH SAPHENOUS-VEIN BYPASS GRAFT LESIONS", Circulation, 91(7), 1995, pp. 1966-1974

Abstract

Background Directional coronary atherectomy and percutaneous transluminal coronary angioplasty have both been used in symptomatic patients with coronary saphenous vein bypass graft stenoses. The relative merits of plaque excision and removal versus balloon dilatation remain uncertain. We compared outcomes after directional coronary atherectomy or angioplasty in patients with de novo bypass graft stenoses. Methods and Results Fifty-four North American and European sites randomized 305 patients with de novo vein graft lesions to atherectomy (n=149) or angioplasty (n=156). Quantitative coronary angiography at a core laboratory assessed initial and 6-month results. Initial angiographic success was greater with atherectomy (89.2% versus 79.0%), as was initial luminal gain (1.45 versus 1.12 mm, P<.001). Distal embolization was increased with atherectomy (P=.012), and a trend was shown toward more non-Q-wave myocardial infarction (P=.09). Although the 6-month net minimum luminal diameter gain was 0.68 mm for atherectomy and 0.50 mm for angioplasty, the restenosis rates were similar, 45.6% for atherectomy and 50.5% for angioplasty (P=.491). At 6 months, there was a trend toward decreased repeated target-vessel interventions for atherectomy (P=.092); in addition, 13.2% of patients treated with atherectomy versus 22.4% of the angioplasty patients (P=.041) required repeated percutaneous intervention of the initial target lesion. Conclusions Atherectomy of de novo vein graft lesions was associated with improved initial angiographic success and luminal diameter but also with increased distal embolization. There was no difference in 6-month restenosis rates, although primary atherectomy patients tended to require fewer target-vessel revascularization procedures.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/09/20 alle ore 09:12:38