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

• 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
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/S0002-9149(97)00135-5

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.