Author + information
- Received October 7, 1994
- Revision received April 14, 1995
- Accepted May 24, 1995
- Published online October 1, 1995.
- Sipke Strikwerda, MD, PhD,
- Eline Montauban van Swijndregt,
- David P. Foley, MD1,
- Eric Boersma, MSc,
- Victor A. Umans, MD, PhD,
- Rein Melkert, MD and
- Patrick W. Serruys, MD, PhD, FACC*
- ↵*Address for correspondence: Dr. Patrick W. Serruys, Catheterization Laboratory, Thoraxcenter, Bd 416, University Hospital Dijkzigt, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam. The Netherlands.
Objectives. This study sought to compare acute lumen changes and late lumen narrowing during and after excimer laser-assisted balloon angioplasty, measured by quantitative coronary angiography, with the immediate and long-term outcome of balloon angioplasty alone.
Background. Although excimer laser coronary angioplasty is used as an adjunct or alternative to balloon angioplasty, limited comparative data exist regarding the immediate and long-term efficacy of excimer laser-assisted balloon angioplasty versus balloon angioplasty alone.
Methods. A series of 53 lesions in 47 consecutive patients successfully treated with excimer laser-assisted balloon angioplasty were individually matched after completion of 6-month follow-up angiography with 53 successfully treated balloon angioplasty lesions according to vessel location, preprocedural minimal lumen diameter and reference diameter. Immediate and long-term angiographic results were assessed by an automated lumen contour detection algorithm.
Results. Before intervention in the laser and balloon angioplasty groups, respectively, minimal lumen diameter (mean ± SD) was 0.73 ± 0.47 and 0.74 ± 0.46 mm, and reference diameter was 2.71 ± 0.42 and 2.72 ± 0.41 mm. Laser angioplasty was followed by adjunctive balloon dilation in 50 lesions. Mean balloon diameter at maximal inflation was similar in both treatment groups (2.61 ± 0.32 and 2.65 ± 0.38 mm, respectively), resulting in similar minimal lumen diameters after intervention of 1.77 ± 0.41 and 1.78 ± 0.34 mm, respectively. At follow-up angiography, minimal lumen diameter after excimer laser-assisted balloon angioplasty was 1.17 ± 0.63 mm, and that after balloon angioplasty alone was 1.46 ± 0.67 mm (p = 0.02). The angiographic restenosis rates at follow-up using the 50% diameter stenosis cutoff criterion were 57% and 34%, respectively (p = 0.02).
Conclusions. Quantitative angiographic analysis of a matched group of 106 successfully treated coronary lesions showed a similar immediate outcome but reduced long-term efficacy of excimer laser-assisted balloon angioplasty compared with that after balloon angioplasty alone.
- Received October 7, 1994.
- Revision received April 14, 1995.
- Accepted May 24, 1995.
- American College of Cardiology