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Titolo:
Angiographic analysis of immediate and long-term results of PTCR vs. PTCA in complex lesions (COBRA study)
Autore:
Dietz, U; Rupprecht, HJ; Ekinci, O; Dill, T; Erbel, R; Kuck, KH; Abdollahnia, R; Rippin, G; Meyer, J; Hamm, C;
Indirizzi:
Univ Hosp, Mainz, Germany Univ Hosp Mainz GermanyUniv Hosp, Mainz, Germany Univ Hosp Eppendorf, Hamburg, Germany Univ Hosp Eppendorf Hamburg Germany iv Hosp Eppendorf, Hamburg, Germany Univ Hosp Essen, Essen, Germany Univ Hosp Essen Essen GermanyUniv Hosp Essen, Essen, Germany Gen Hosp St Georg, Hamburg, Germany Gen Hosp St Georg Hamburg GermanyGen Hosp St Georg, Hamburg, Germany
Titolo Testata:
CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS
fascicolo: 3, volume: 53, anno: 2001,
pagine: 359 - 367
SICI:
1522-1946(200107)53:3<359:AAOIAL>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
QUANTITATIVE CORONARY ANGIOGRAPHY; SPEED ROTATIONAL ATHERECTOMY; BALLOON ANGIOPLASTY; ARTERY DISEASE; EXCIMER-LASER; QCA SYSTEMS; INTERVENTION; MORPHOLOGY; RESTENOSIS; STENOSES;
Keywords:
coronary artery disease; percutaneous transluminal coronary angioplasty; (PTCA); rotational atherectomy (PTCR); complex coronary artery lesion;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
32
Recensione:
Indirizzi per estratti:
Indirizzo: Dietz, U Deutsch Klin Diagnost, Aukammallee 33, D-65191 Wiesbaden, GermanyDeutsch Klin Diagnost Aukammallee 33 Wiesbaden Germany D-65191 y
Citazione:
U. Dietz et al., "Angiographic analysis of immediate and long-term results of PTCR vs. PTCA in complex lesions (COBRA study)", CATHET C IN, 53(3), 2001, pp. 359-367

Abstract

We conducted a prospective, randomized trial to compare immediate and long-term effects of percutaneous transluminal coronary angioplasty (PTCA) and high-frequency rotational atherectomy (PTCR) in patients with angiographically predefined complex coronary artery lesions (AHA type B2 and C). The relation of lesion characteristics to procedural results is reported in this angiographic analysis. Patients were randomly assigned to balloon angioplasty (n = 250 patients) or rotational atherectomy (n = 252 patients). Quantitative coronary angiography could be performed in 447 patients to evaluate immediate results and in 293 patients with a 6-month angiographic follow-up. Procedural success was comparable in the PTCR and in the PTCA group (80% vs. 76%, P = 0.260). The need for stent implantation due to a residual stenosis > 50% or a bail-out situation was significantly higher in the PTCA group(9.7% vs. 2.0%, P = 0.0011. In both treatment groups, diameter stenosis was effectively reduced and MLD increased. The acute gain did not differ between the two groups. At 8-month control, the restenosis rate was comparable in the PTCR and in the PTCA group (37% vs. 35%, P = 0.658), whereas diameter stenosis was significantly more severe in the PTCR group than in the PTCAgroup (52% vs. 46%, P = 0.039) and, correspondingly, the MLD was significantly smaller in the PTCR group 11.29 mm vs. 1.44 mm, P = 0.031). Late loss was about the same in both groups, however, net gain and net gain index were significantly higher in the PTCA group (0.82 mm vs. 0.64 mm, P = 0.008; acid 31% vs. 24%, P = 0.009). Analysis of procedural results for various lesion characteristics revealed no significant difference between treatment groups. In this randomized trial, complex coronary artery lesions were treated with comparable results for angiographic and procedural success and the restenosis rate by both, PTCA and PTCR. Late loss, however, was significantly higher and net gain significantly smaller after PTCR. Stents, although infrequently used, had a relevant impact on immediate PTCA results but not onlate results. (C) 2001 Wiley-Liss, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 18/01/20 alle ore 22:09:20