Comparison of balloon angioplasty versus debulking devices versus stenting in right coronary ostial lesions

Angioplasty of aorto-osrial stenosis is associated with lower procedural success and a higher complication rate. The aim of the present study was to compare the acute and long-term results of balloon and new device angioplasty in 110 consecutive patients with right coronary ostial lesions. Patients...

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Bibliographic Details
Published in:The American journal of cardiology 1997-05, Vol.79 (10), p.1334-1338
Main Authors: Jain, Suresh P., Liu, Ming W., Dean, Larry S., Babu, Ramesh, Goods, Christopher M., Yadav, Jay S., Al-Shaibi, Khaled F., Mathur, Atul, Iyer, Sriram S., Parks, J.Michael, Baxley, William A., Roubin, Gary S.
Format: Article
Language:English
Subjects:
Aged
Angioplasty
Angioplasty, Balloon, Coronary
Angioplasty, Balloon, Laser-Assisted
Atherectomy, Coronary
Cardiovascular disease
Coronary Disease - therapy
Female
Follow-Up Studies
Humans
Male
Middle Aged
Postoperative Complications
Retrospective Studies
Stents
Treatment Outcome
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Summary:Angioplasty of aorto-osrial stenosis is associated with lower procedural success and a higher complication rate. The aim of the present study was to compare the acute and long-term results of balloon and new device angioplasty in 110 consecutive patients with right coronary ostial lesions. Patients were divided into 3 groups according to the angioplasty device used: group I (balloon only, n = 26), group II (debulking devices including excimer laser, directional and rotational atherectomy, n = 26), group III (stent, n = 58). Procedural success was highest in group III (96%) followed by group I (88%), and group II (77%). In-hospital complications were similar among the groups (p = NS). Patients in group III achieved the highest acute gain (2.61 mm) followed by groups II (1.92 mm), and I (1.39 mm, p < 0.05). During follow up, target lesion revascularization and/or bypass surgery was required in 24% of patients in group III compared with 47% and 40% in groups I and II, respectively (p < 0.05). Cardiac-event free survival was highest in the stent group (74%, p < 0.005) and was similar between the balloon (39%) and debulking device groups (45%). Thus, among the currently available technologies, stenting of right coronary ostial lesions appears to provide excellent angiographic and long-term results.
ISSN:0002-9149
1879-1913
DOI:10.1016/S0002-9149(97)00135-5