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Titolo:
Evaluation of the long-term functional outcome assessed by myocardial perfusion scintigraphy following excimer laser angioplasty compared to balloon angioplasty in longer coronary lesions
Autore:
Appelman, YEA; Piek, JJ; van der Wall, EE; Redekop, WK; van Royen, EA; Fioretti, PM; de Feyter, PJ; Koolen, JJ; Strikwerda, S; Serruys, PW; David, GK; Tijssen, JGP; Lie, KI;
Indirizzi:
Univ Amsterdam, Acad Med Ctr, Dept Cardiol, NL-1105 AZ Amsterdam, Netherlands Univ Amsterdam Amsterdam Netherlands NL-1105 AZ Z Amsterdam, Netherlands Univ Amsterdam, Acad Med Ctr, Dept Clin Epidemiol & Biostat, NL-1105 AZ Amsterdam, Netherlands Univ Amsterdam Amsterdam Netherlands NL-1105 AZ Z Amsterdam, Netherlands Univ Amsterdam, Acad Med Ctr, Dept Nucl Med, NL-1105 AZ Amsterdam, Netherlands Univ Amsterdam Amsterdam Netherlands NL-1105 AZ Z Amsterdam, Netherlands Erasmus Univ, Hosp Dijkzigt, Thoraxctr, NL-3015 GD Rotterdam, Netherlands Erasmus Univ Rotterdam Netherlands NL-3015 GD GD Rotterdam, Netherlands Leiden Univ, Med Ctr, Dept Cardiol, NL-2300 RA Leiden, Netherlands Leiden Univ Leiden Netherlands NL-2300 RA NL-2300 RA Leiden, Netherlands Catharina Hosp, Dept Cardiol, Eindhoven, Netherlands Catharina Hosp Eindhoven Netherlands pt Cardiol, Eindhoven, Netherlands Hosp De Barone, Dept Cardiol, Breda, Netherlands Hosp De Barone Breda Netherlands rone, Dept Cardiol, Breda, Netherlands
Titolo Testata:
INTERNATIONAL JOURNAL OF CARDIAC IMAGING
fascicolo: 4, volume: 16, anno: 2000,
pagine: 267 - 277
SICI:
0167-9899(200008)16:4<267:EOTLFO>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
ARTERY DISEASE; RANDOMIZED TRIAL; BYPASS-SURGERY; EXERCISE; TL-201; ELECTROCARDIOGRAPHY; DIPYRIDAMOLE; RESTENOSIS; TOMOGRAPHY; REST;
Keywords:
balloon angioplasty; coronary artery disease; laser angioplasty; laser-assisted balloon angioplasty; percutaneous transluminal laser angioplasty; randomized trial; myocardial perfusion scintigraphy;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Piek, JJ Univ Amsterdam, Acad Med Ctr, Dept Cardiol, Meibergdreef 9,B2-109, NL-1105AZ Amsterdam, Netherlands Univ Amsterdam Meibergdreef 9,B2-109 Amsterdam Netherlands NL-1105 AZ
Citazione:
Y.E.A. Appelman et al., "Evaluation of the long-term functional outcome assessed by myocardial perfusion scintigraphy following excimer laser angioplasty compared to balloon angioplasty in longer coronary lesions", INT J CAR I, 16(4), 2000, pp. 267-277

Abstract

Objectives: Evaluation of the long-term functional outcome assessed by exercise myocardial perfusion imaging following excimer laser angioplasty compared to balloon angioplasty in coronary lesions > 10 mm in length. Background: Previous randomized studies evaluating the effect of coronary interventions mainly focused on the long-term clinical and angiographic outcome. Thefunctional outcome, assessed by myocardial perfusion scintigraphy, has notbeen evaluated in a randomized setting. Methods: A total of 308 patients with stable angina and a longer coronary lesion (> 10 mm) were randomized toexcimer laser angioplasty or balloon angioplasty. A (99m)mTechnetium-2-methoxy isobutyl isonitrile (MIBI) single-photon emission computed tomography (SPECT) study was performed in 139 patients before the initial angioplasty procedure and at 6 months follow-up (73 patients in the laser group versus 66 patients in the balloon group, respectively). Exercise tolerance at follow-up was compared to baseline values by means of exercise duration and double product at peak exercise. Myocardial perfusion of the randomized vascular bed was assessed semi-quantitatively on the MIBI SPECT images. The reversible defects were graded as mild, moderate or severe. Myocardial perfusionat follow-up was expressed as a percentage reduction in incidence and grading of the reversible defects compared to baseline values. Results: Forty-four (61%) patients assigned to laser angioplasty were asymptomatic at 6 months follow-up compared to 34 (52%) patients assigned to balloon angioplasty(p = NS). Improvement in exercise duration and double product were 0.7 +/-2.1 min and 4.3 +/- 6.2 min/mmHg/1000, respectively, in the laser group, versus 0.3 +/- 2.5 min and 3.1 +/- 5.5 min/mmHg/1000, respectively, in the balloon group (both p = NS). The percentage reduction of reversible defects was 23% in patients assigned to laser angioplasty vs. 29% in patients assigned to balloon angioplasty (Relative risk [RR]: 0.79, 95% confidence interval [CI]: 0.40-1.57; p = 0.50). The mild, moderate and severe reversible defects improved in 44.4, 63.6 and 66.6%, respectively, in the laser angioplasty group vs. 66.6, 53.8 and 90%, respectively, in the balloon angioplasty group. None of the comparisons were significantly different. Conclusion: Excimer laser angioplasty compared to balloon angioplasty in coronary lesions > 10 mm in length yields a similar long-term functional outcome assessed byanginal status, exercise tolerance and myocardial perfusion.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/07/20 alle ore 18:29:30