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Angiographic analysis of immediate and long-term results of PTCR vs. PTCA in complex lesions (COBRA study)
Catheterization and cardiovascular interventions, 2001-07, Vol.53 (3), p.359-367
Dietz, Ulrich
Rupprecht, Hans-Juergen
Ekinci, Okan
Dill, Thorsten
Erbel, Raimund
Kuck, Karl-Heinz
Abdollahnia, Reza
Rippin, Gerd
Meyer, Juergen
Hamm, Christian
2001
Details
Autor(en) / Beteiligte
Dietz, Ulrich
Rupprecht, Hans-Juergen
Ekinci, Okan
Dill, Thorsten
Erbel, Raimund
Kuck, Karl-Heinz
Abdollahnia, Reza
Rippin, Gerd
Meyer, Juergen
Hamm, Christian
Titel
Angiographic analysis of immediate and long-term results of PTCR vs. PTCA in complex lesions (COBRA study)
Ist Teil von
Catheterization and cardiovascular interventions, 2001-07, Vol.53 (3), p.359-367
Ort / Verlag
New York: John Wiley & Sons, Inc
Erscheinungsjahr
2001
Link zum Volltext
Quelle
MEDLINE
Beschreibungen/Notizen
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 = 0.001). In both treatment groups, diameter stenosis was effectively reduced and MLD increased. The acute gain did not differ between the two groups. At 6‐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 PTCA group (52% vs. 46%, P = 0.039) and, correspondingly, the MLD was significantly smaller in the PTCR group (1.29 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; and 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 on late results. Cathet Cardiovasc Intervent 2001;53:359–367. © 2001 Wiley‐Liss, Inc.
Sprache
Englisch
Identifikatoren
ISSN: 1522-1946
eISSN: 1522-726X
DOI: 10.1002/ccd.1181
Titel-ID: cdi_proquest_miscellaneous_71008820
Format
–
Schlagworte
Aged
,
Angioplasty, Balloon, Coronary
,
Atherectomy, Coronary
,
Biological and medical sciences
,
complex coronary artery lesion
,
Coronary Angiography
,
coronary artery disease
,
Coronary Disease - diagnostic imaging
,
Coronary Disease - therapy
,
Coronary Vessels - surgery
,
Diseases of the cardiovascular system
,
Female
,
Graft Occlusion, Vascular - diagnostic imaging
,
Humans
,
Male
,
Medical sciences
,
Middle Aged
,
percutaneous transluminal coronary angioplasty (PTCA)
,
Prospective Studies
,
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
,
rotational atherectomy (PTCR)
,
Stents
,
Time Factors
,
Treatment Outcome
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