Prospective, randomized, multicenter comparison of laser-facilitated balloon angioplasty versus stand-alone balloon angioplasty in patients with obstructive coronary artery disease

Gregg W. Stone, Eduardo De Marchena, David Dageforde, Alberto Foschi, Joseph B. Muhlestein, Michael McIvor, David Rizik, Ronald Vanderlaan, Joann McDonnell

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Objectives. The goal of this study was to examine the relative safety and efficacy of laser-facilitated percutaneous transluminal coronary angioplasty (PTCA) versus 'stand-alone' PTCA. Background. Plaque debulking with lasing before PTCA may result in improved lumen dimensions and decreased rates of periprocedural ischemic complications, thus improving short-and long-term outcomes after percutaneous intervention. The mid-infrared holmium:yttrium-aluminum-garnet (YAG) laser has been shown to be effective in a variety of plaque subtypes and may be particularly useful in high risk acute ischemic syndromes. Methods. A total of 215 patients (mean [ ± SD] age 61 ± 12 years) with 244 lesions were prospectively randomized at 14 clinical centers to laser versus stand-alone PICA. After laser treatment, all patients underwent PICA; 148 patients (69%) had unstable angina. Results. The procedural success rate without major catheterization laboratory complications was similar in patients assigned to laser treatment or PTCA alone (96.6% vs. 96.9%, p = 0.88), as was the in-hospital clinical success rate (89.7% vs. 93.9%, p = 0.27). There was no difference in postprocedural diameter stenosis after laser treatment compared with PTCA (18.3% ± 13.6% vs. 19.5% ± 15.1%, p = 0.50). However, use of the laser, versus PICA alone, did result in significantly more major and minor procedural complications (18.0% vs. 3.1%, p = 0.0004), myocardial infarctions (4.3% vs. 0%, p = 0.04) and total in-hospital major adverse events (10.3% vs. 4.1%, p = 0.08). At a mean follow-up time of 11.2 ± 7.7 months, there were no differences in late or event-free survival in patients assigned to laser treatment versus PICA alone. Conclusions. Compared with stand-alone PTCA, laser-facilitated FICA results in a more complicated hospital course, without immediate or long- term benefits.

Original languageEnglish
Pages (from-to)1714-1721
Number of pages8
JournalJournal of the American College of Cardiology
Volume30
Issue number7
DOIs
StatePublished - Dec 1 1997

Fingerprint

Laser-Assisted Balloon Angioplasty
Balloon Angioplasty
Coronary Balloon Angioplasty
Coronary Artery Disease
Lasers
Holmium
Unstable Angina
Solid-State Lasers
Therapeutics
Catheterization
Disease-Free Survival
Pathologic Constriction
Myocardial Infarction

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Prospective, randomized, multicenter comparison of laser-facilitated balloon angioplasty versus stand-alone balloon angioplasty in patients with obstructive coronary artery disease. / Stone, Gregg W.; De Marchena, Eduardo; Dageforde, David; Foschi, Alberto; Muhlestein, Joseph B.; McIvor, Michael; Rizik, David; Vanderlaan, Ronald; McDonnell, Joann.

In: Journal of the American College of Cardiology, Vol. 30, No. 7, 01.12.1997, p. 1714-1721.

Research output: Contribution to journalArticle

Stone, Gregg W. ; De Marchena, Eduardo ; Dageforde, David ; Foschi, Alberto ; Muhlestein, Joseph B. ; McIvor, Michael ; Rizik, David ; Vanderlaan, Ronald ; McDonnell, Joann. / Prospective, randomized, multicenter comparison of laser-facilitated balloon angioplasty versus stand-alone balloon angioplasty in patients with obstructive coronary artery disease. In: Journal of the American College of Cardiology. 1997 ; Vol. 30, No. 7. pp. 1714-1721.
@article{f35c59f632b040b295c28388a46c29f7,
title = "Prospective, randomized, multicenter comparison of laser-facilitated balloon angioplasty versus stand-alone balloon angioplasty in patients with obstructive coronary artery disease",
abstract = "Objectives. The goal of this study was to examine the relative safety and efficacy of laser-facilitated percutaneous transluminal coronary angioplasty (PTCA) versus 'stand-alone' PTCA. Background. Plaque debulking with lasing before PTCA may result in improved lumen dimensions and decreased rates of periprocedural ischemic complications, thus improving short-and long-term outcomes after percutaneous intervention. The mid-infrared holmium:yttrium-aluminum-garnet (YAG) laser has been shown to be effective in a variety of plaque subtypes and may be particularly useful in high risk acute ischemic syndromes. Methods. A total of 215 patients (mean [ ± SD] age 61 ± 12 years) with 244 lesions were prospectively randomized at 14 clinical centers to laser versus stand-alone PICA. After laser treatment, all patients underwent PICA; 148 patients (69{\%}) had unstable angina. Results. The procedural success rate without major catheterization laboratory complications was similar in patients assigned to laser treatment or PTCA alone (96.6{\%} vs. 96.9{\%}, p = 0.88), as was the in-hospital clinical success rate (89.7{\%} vs. 93.9{\%}, p = 0.27). There was no difference in postprocedural diameter stenosis after laser treatment compared with PTCA (18.3{\%} ± 13.6{\%} vs. 19.5{\%} ± 15.1{\%}, p = 0.50). However, use of the laser, versus PICA alone, did result in significantly more major and minor procedural complications (18.0{\%} vs. 3.1{\%}, p = 0.0004), myocardial infarctions (4.3{\%} vs. 0{\%}, p = 0.04) and total in-hospital major adverse events (10.3{\%} vs. 4.1{\%}, p = 0.08). At a mean follow-up time of 11.2 ± 7.7 months, there were no differences in late or event-free survival in patients assigned to laser treatment versus PICA alone. Conclusions. Compared with stand-alone PTCA, laser-facilitated FICA results in a more complicated hospital course, without immediate or long- term benefits.",
author = "Stone, {Gregg W.} and {De Marchena}, Eduardo and David Dageforde and Alberto Foschi and Muhlestein, {Joseph B.} and Michael McIvor and David Rizik and Ronald Vanderlaan and Joann McDonnell",
year = "1997",
month = "12",
day = "1",
doi = "10.1016/S0735-1097(97)00387-2",
language = "English",
volume = "30",
pages = "1714--1721",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "7",

}

TY - JOUR

T1 - Prospective, randomized, multicenter comparison of laser-facilitated balloon angioplasty versus stand-alone balloon angioplasty in patients with obstructive coronary artery disease

AU - Stone, Gregg W.

AU - De Marchena, Eduardo

AU - Dageforde, David

AU - Foschi, Alberto

AU - Muhlestein, Joseph B.

AU - McIvor, Michael

AU - Rizik, David

AU - Vanderlaan, Ronald

AU - McDonnell, Joann

PY - 1997/12/1

Y1 - 1997/12/1

N2 - Objectives. The goal of this study was to examine the relative safety and efficacy of laser-facilitated percutaneous transluminal coronary angioplasty (PTCA) versus 'stand-alone' PTCA. Background. Plaque debulking with lasing before PTCA may result in improved lumen dimensions and decreased rates of periprocedural ischemic complications, thus improving short-and long-term outcomes after percutaneous intervention. The mid-infrared holmium:yttrium-aluminum-garnet (YAG) laser has been shown to be effective in a variety of plaque subtypes and may be particularly useful in high risk acute ischemic syndromes. Methods. A total of 215 patients (mean [ ± SD] age 61 ± 12 years) with 244 lesions were prospectively randomized at 14 clinical centers to laser versus stand-alone PICA. After laser treatment, all patients underwent PICA; 148 patients (69%) had unstable angina. Results. The procedural success rate without major catheterization laboratory complications was similar in patients assigned to laser treatment or PTCA alone (96.6% vs. 96.9%, p = 0.88), as was the in-hospital clinical success rate (89.7% vs. 93.9%, p = 0.27). There was no difference in postprocedural diameter stenosis after laser treatment compared with PTCA (18.3% ± 13.6% vs. 19.5% ± 15.1%, p = 0.50). However, use of the laser, versus PICA alone, did result in significantly more major and minor procedural complications (18.0% vs. 3.1%, p = 0.0004), myocardial infarctions (4.3% vs. 0%, p = 0.04) and total in-hospital major adverse events (10.3% vs. 4.1%, p = 0.08). At a mean follow-up time of 11.2 ± 7.7 months, there were no differences in late or event-free survival in patients assigned to laser treatment versus PICA alone. Conclusions. Compared with stand-alone PTCA, laser-facilitated FICA results in a more complicated hospital course, without immediate or long- term benefits.

AB - Objectives. The goal of this study was to examine the relative safety and efficacy of laser-facilitated percutaneous transluminal coronary angioplasty (PTCA) versus 'stand-alone' PTCA. Background. Plaque debulking with lasing before PTCA may result in improved lumen dimensions and decreased rates of periprocedural ischemic complications, thus improving short-and long-term outcomes after percutaneous intervention. The mid-infrared holmium:yttrium-aluminum-garnet (YAG) laser has been shown to be effective in a variety of plaque subtypes and may be particularly useful in high risk acute ischemic syndromes. Methods. A total of 215 patients (mean [ ± SD] age 61 ± 12 years) with 244 lesions were prospectively randomized at 14 clinical centers to laser versus stand-alone PICA. After laser treatment, all patients underwent PICA; 148 patients (69%) had unstable angina. Results. The procedural success rate without major catheterization laboratory complications was similar in patients assigned to laser treatment or PTCA alone (96.6% vs. 96.9%, p = 0.88), as was the in-hospital clinical success rate (89.7% vs. 93.9%, p = 0.27). There was no difference in postprocedural diameter stenosis after laser treatment compared with PTCA (18.3% ± 13.6% vs. 19.5% ± 15.1%, p = 0.50). However, use of the laser, versus PICA alone, did result in significantly more major and minor procedural complications (18.0% vs. 3.1%, p = 0.0004), myocardial infarctions (4.3% vs. 0%, p = 0.04) and total in-hospital major adverse events (10.3% vs. 4.1%, p = 0.08). At a mean follow-up time of 11.2 ± 7.7 months, there were no differences in late or event-free survival in patients assigned to laser treatment versus PICA alone. Conclusions. Compared with stand-alone PTCA, laser-facilitated FICA results in a more complicated hospital course, without immediate or long- term benefits.

UR - http://www.scopus.com/inward/record.url?scp=9844247560&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=9844247560&partnerID=8YFLogxK

U2 - 10.1016/S0735-1097(97)00387-2

DO - 10.1016/S0735-1097(97)00387-2

M3 - Article

C2 - 9385898

AN - SCOPUS:9844247560

VL - 30

SP - 1714

EP - 1721

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 7

ER -