Six-month clinical and angiographic outcome after successful excimer laser angioplasty for in-stent restenosis
OBJECTIVES This study evaluated the clinical and angiographic six-month follow-up after excimer laser coronary angioplasty (ELCA) for restenosed coronary stents. BACKGROUND Excimer laser coronary angioplasty has recently been shown to be safe and efficient for the treatment of in-stent restenosis. M...
Gespeichert in:
Veröffentlicht in: | Journal of the American College of Cardiology 2000-07, Vol.36 (1), p.69-74 |
---|---|
Hauptverfasser: | , , , , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 74 |
---|---|
container_issue | 1 |
container_start_page | 69 |
container_title | Journal of the American College of Cardiology |
container_volume | 36 |
creator | Köster, Ralf Kähler, Jan Terres, Wolfram Reimers, Jacobus Baldus, Stephan Hartig, Dirk Berger, Jürgen Meinertz, Thomas Hamm, Christian W |
description | OBJECTIVES
This study evaluated the clinical and angiographic six-month follow-up after excimer laser coronary angioplasty (ELCA) for restenosed coronary stents.
BACKGROUND
Excimer laser coronary angioplasty has recently been shown to be safe and efficient for the treatment of in-stent restenosis.
METHODS
Ninety-six consecutive patients successfully treated with ELCA within 141 stents were included in a six-month clinical and angiographic follow-up.
RESULTS
During follow-up there was one sudden death and one patient with documented myocardial infarction. Angina pectoris classified as ≥ Canadian Cardiovascular Society II reoccurred in 49 patients. Follow-up angiography was obtained in 89 patients (93%) with 133 stents. Quantitative coronary angiography revealed a mean diameter stenosis of 77 ± 10% before intervention, 41 ± 12% after laser treatment and 11% ± 12% after adjunctive percutaneous transluminal coronary angioplasty (p < 0.001). Six months after ELCA the mean diameter stenosis had increased to 60 ± 26% (p < 0.001). A ≥50% diameter stenosis was present in 48 patients (54%); in 24 of these patients diameter stenosis was ≥70%. Total occlusions occurred in an additional 10 patients (11%). There was a trend toward an increased recurrent restenosis rate in patients with diabetes mellitus and long lesions or total occlusions (p = 0.059). Forty-eight patients (50%) received medical treatment after six months. Reinterventions were necessary in 30 patients (31%), and coronary artery bypass surgery was performed in 17 patients (18%). Event-free survival was 50%.
CONCLUSIONS
Excimer laser angioplasty for in-stent restenosis was associated with a high incidence of recurrent restenosis in this group of patients, suggesting that this technique is unlikely to reduce recurrent in-stent restenosis and that other approaches are necessary. |
doi_str_mv | 10.1016/S0735-1097(00)00704-X |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_71234538</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S073510970000704X</els_id><sourcerecordid>71234538</sourcerecordid><originalsourceid>FETCH-LOGICAL-c491t-5e79e254395e49dc81d6d389d817d411a5a13f391f37501d91738ecd044df71c3</originalsourceid><addsrcrecordid>eNqFkE1vVSEQhonR2Gv1J2hYmEYXR5kCF1gZ01Rr0sRFNemOIAwt5hy4wjmm_fdyP6LduYCZkOedIQ8hL4G9Awbr91dMcTkAM-oNY28ZU0wM14_ICqTUA5dGPSarv8gRedbaT8bYWoN5So6AaaMFyBXJV-lumEqeb6kfU07ejdTl0M9NKjfVbW6Tp2WZfZmQujhjpW3xHluLy0jxzqepP42u9XuX2fR-vqexVJry0GbMM624raWl9pw8iW5s-OJQj8n3T-ffzi6Gy6-fv5x9vBy8MDAPEpXBUym4kShM8BrCOnBtggYVBICTDnjkBiJXkkEwoLhGH5gQISrw_Jic7Oduavm19PV2Ss3jOLqMZWlWwSkXkusOyj3oa2mtYrSbmiZX7y0wuxVtd6Lt1qJlzO5E2-uee3VYsPyYMDxI7c124PUBcK1LjdVln9o_TvThYot92GPYbfxOWG3zCbPHkCr62YaS_vOTP7V7m9k</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>71234538</pqid></control><display><type>article</type><title>Six-month clinical and angiographic outcome after successful excimer laser angioplasty for in-stent restenosis</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Köster, Ralf ; Kähler, Jan ; Terres, Wolfram ; Reimers, Jacobus ; Baldus, Stephan ; Hartig, Dirk ; Berger, Jürgen ; Meinertz, Thomas ; Hamm, Christian W</creator><creatorcontrib>Köster, Ralf ; Kähler, Jan ; Terres, Wolfram ; Reimers, Jacobus ; Baldus, Stephan ; Hartig, Dirk ; Berger, Jürgen ; Meinertz, Thomas ; Hamm, Christian W</creatorcontrib><description>OBJECTIVES
This study evaluated the clinical and angiographic six-month follow-up after excimer laser coronary angioplasty (ELCA) for restenosed coronary stents.
BACKGROUND
Excimer laser coronary angioplasty has recently been shown to be safe and efficient for the treatment of in-stent restenosis.
METHODS
Ninety-six consecutive patients successfully treated with ELCA within 141 stents were included in a six-month clinical and angiographic follow-up.
RESULTS
During follow-up there was one sudden death and one patient with documented myocardial infarction. Angina pectoris classified as ≥ Canadian Cardiovascular Society II reoccurred in 49 patients. Follow-up angiography was obtained in 89 patients (93%) with 133 stents. Quantitative coronary angiography revealed a mean diameter stenosis of 77 ± 10% before intervention, 41 ± 12% after laser treatment and 11% ± 12% after adjunctive percutaneous transluminal coronary angioplasty (p < 0.001). Six months after ELCA the mean diameter stenosis had increased to 60 ± 26% (p < 0.001). A ≥50% diameter stenosis was present in 48 patients (54%); in 24 of these patients diameter stenosis was ≥70%. Total occlusions occurred in an additional 10 patients (11%). There was a trend toward an increased recurrent restenosis rate in patients with diabetes mellitus and long lesions or total occlusions (p = 0.059). Forty-eight patients (50%) received medical treatment after six months. Reinterventions were necessary in 30 patients (31%), and coronary artery bypass surgery was performed in 17 patients (18%). Event-free survival was 50%.
CONCLUSIONS
Excimer laser angioplasty for in-stent restenosis was associated with a high incidence of recurrent restenosis in this group of patients, suggesting that this technique is unlikely to reduce recurrent in-stent restenosis and that other approaches are necessary.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/S0735-1097(00)00704-X</identifier><identifier>PMID: 10898415</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Angioplasty, Balloon, Coronary - methods ; Angioplasty, Balloon, Laser-Assisted ; Biological and medical sciences ; Coronary Angiography ; Coronary Disease - diagnostic imaging ; Coronary Disease - surgery ; Disease-Free Survival ; Diseases of the cardiovascular system ; Female ; Follow-Up Studies ; Humans ; Male ; Medical sciences ; Middle Aged ; Prevalence ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Recurrence ; Reoperation ; Stents ; Treatment Outcome</subject><ispartof>Journal of the American College of Cardiology, 2000-07, Vol.36 (1), p.69-74</ispartof><rights>2000 American College of Cardiology</rights><rights>2000 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c491t-5e79e254395e49dc81d6d389d817d411a5a13f391f37501d91738ecd044df71c3</citedby><cites>FETCH-LOGICAL-c491t-5e79e254395e49dc81d6d389d817d411a5a13f391f37501d91738ecd044df71c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0735-1097(00)00704-X$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1410145$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10898415$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Köster, Ralf</creatorcontrib><creatorcontrib>Kähler, Jan</creatorcontrib><creatorcontrib>Terres, Wolfram</creatorcontrib><creatorcontrib>Reimers, Jacobus</creatorcontrib><creatorcontrib>Baldus, Stephan</creatorcontrib><creatorcontrib>Hartig, Dirk</creatorcontrib><creatorcontrib>Berger, Jürgen</creatorcontrib><creatorcontrib>Meinertz, Thomas</creatorcontrib><creatorcontrib>Hamm, Christian W</creatorcontrib><title>Six-month clinical and angiographic outcome after successful excimer laser angioplasty for in-stent restenosis</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>OBJECTIVES
This study evaluated the clinical and angiographic six-month follow-up after excimer laser coronary angioplasty (ELCA) for restenosed coronary stents.
BACKGROUND
Excimer laser coronary angioplasty has recently been shown to be safe and efficient for the treatment of in-stent restenosis.
METHODS
Ninety-six consecutive patients successfully treated with ELCA within 141 stents were included in a six-month clinical and angiographic follow-up.
RESULTS
During follow-up there was one sudden death and one patient with documented myocardial infarction. Angina pectoris classified as ≥ Canadian Cardiovascular Society II reoccurred in 49 patients. Follow-up angiography was obtained in 89 patients (93%) with 133 stents. Quantitative coronary angiography revealed a mean diameter stenosis of 77 ± 10% before intervention, 41 ± 12% after laser treatment and 11% ± 12% after adjunctive percutaneous transluminal coronary angioplasty (p < 0.001). Six months after ELCA the mean diameter stenosis had increased to 60 ± 26% (p < 0.001). A ≥50% diameter stenosis was present in 48 patients (54%); in 24 of these patients diameter stenosis was ≥70%. Total occlusions occurred in an additional 10 patients (11%). There was a trend toward an increased recurrent restenosis rate in patients with diabetes mellitus and long lesions or total occlusions (p = 0.059). Forty-eight patients (50%) received medical treatment after six months. Reinterventions were necessary in 30 patients (31%), and coronary artery bypass surgery was performed in 17 patients (18%). Event-free survival was 50%.
CONCLUSIONS
Excimer laser angioplasty for in-stent restenosis was associated with a high incidence of recurrent restenosis in this group of patients, suggesting that this technique is unlikely to reduce recurrent in-stent restenosis and that other approaches are necessary.</description><subject>Adult</subject><subject>Aged</subject><subject>Angioplasty, Balloon, Coronary - methods</subject><subject>Angioplasty, Balloon, Laser-Assisted</subject><subject>Biological and medical sciences</subject><subject>Coronary Angiography</subject><subject>Coronary Disease - diagnostic imaging</subject><subject>Coronary Disease - surgery</subject><subject>Disease-Free Survival</subject><subject>Diseases of the cardiovascular system</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Prevalence</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Recurrence</subject><subject>Reoperation</subject><subject>Stents</subject><subject>Treatment Outcome</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1vVSEQhonR2Gv1J2hYmEYXR5kCF1gZ01Rr0sRFNemOIAwt5hy4wjmm_fdyP6LduYCZkOedIQ8hL4G9Awbr91dMcTkAM-oNY28ZU0wM14_ICqTUA5dGPSarv8gRedbaT8bYWoN5So6AaaMFyBXJV-lumEqeb6kfU07ejdTl0M9NKjfVbW6Tp2WZfZmQujhjpW3xHluLy0jxzqepP42u9XuX2fR-vqexVJry0GbMM624raWl9pw8iW5s-OJQj8n3T-ffzi6Gy6-fv5x9vBy8MDAPEpXBUym4kShM8BrCOnBtggYVBICTDnjkBiJXkkEwoLhGH5gQISrw_Jic7Oduavm19PV2Ss3jOLqMZWlWwSkXkusOyj3oa2mtYrSbmiZX7y0wuxVtd6Lt1qJlzO5E2-uee3VYsPyYMDxI7c124PUBcK1LjdVln9o_TvThYot92GPYbfxOWG3zCbPHkCr62YaS_vOTP7V7m9k</recordid><startdate>20000701</startdate><enddate>20000701</enddate><creator>Köster, Ralf</creator><creator>Kähler, Jan</creator><creator>Terres, Wolfram</creator><creator>Reimers, Jacobus</creator><creator>Baldus, Stephan</creator><creator>Hartig, Dirk</creator><creator>Berger, Jürgen</creator><creator>Meinertz, Thomas</creator><creator>Hamm, Christian W</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20000701</creationdate><title>Six-month clinical and angiographic outcome after successful excimer laser angioplasty for in-stent restenosis</title><author>Köster, Ralf ; Kähler, Jan ; Terres, Wolfram ; Reimers, Jacobus ; Baldus, Stephan ; Hartig, Dirk ; Berger, Jürgen ; Meinertz, Thomas ; Hamm, Christian W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c491t-5e79e254395e49dc81d6d389d817d411a5a13f391f37501d91738ecd044df71c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Angioplasty, Balloon, Coronary - methods</topic><topic>Angioplasty, Balloon, Laser-Assisted</topic><topic>Biological and medical sciences</topic><topic>Coronary Angiography</topic><topic>Coronary Disease - diagnostic imaging</topic><topic>Coronary Disease - surgery</topic><topic>Disease-Free Survival</topic><topic>Diseases of the cardiovascular system</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Prevalence</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Recurrence</topic><topic>Reoperation</topic><topic>Stents</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Köster, Ralf</creatorcontrib><creatorcontrib>Kähler, Jan</creatorcontrib><creatorcontrib>Terres, Wolfram</creatorcontrib><creatorcontrib>Reimers, Jacobus</creatorcontrib><creatorcontrib>Baldus, Stephan</creatorcontrib><creatorcontrib>Hartig, Dirk</creatorcontrib><creatorcontrib>Berger, Jürgen</creatorcontrib><creatorcontrib>Meinertz, Thomas</creatorcontrib><creatorcontrib>Hamm, Christian W</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Köster, Ralf</au><au>Kähler, Jan</au><au>Terres, Wolfram</au><au>Reimers, Jacobus</au><au>Baldus, Stephan</au><au>Hartig, Dirk</au><au>Berger, Jürgen</au><au>Meinertz, Thomas</au><au>Hamm, Christian W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Six-month clinical and angiographic outcome after successful excimer laser angioplasty for in-stent restenosis</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>2000-07-01</date><risdate>2000</risdate><volume>36</volume><issue>1</issue><spage>69</spage><epage>74</epage><pages>69-74</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract>OBJECTIVES
This study evaluated the clinical and angiographic six-month follow-up after excimer laser coronary angioplasty (ELCA) for restenosed coronary stents.
BACKGROUND
Excimer laser coronary angioplasty has recently been shown to be safe and efficient for the treatment of in-stent restenosis.
METHODS
Ninety-six consecutive patients successfully treated with ELCA within 141 stents were included in a six-month clinical and angiographic follow-up.
RESULTS
During follow-up there was one sudden death and one patient with documented myocardial infarction. Angina pectoris classified as ≥ Canadian Cardiovascular Society II reoccurred in 49 patients. Follow-up angiography was obtained in 89 patients (93%) with 133 stents. Quantitative coronary angiography revealed a mean diameter stenosis of 77 ± 10% before intervention, 41 ± 12% after laser treatment and 11% ± 12% after adjunctive percutaneous transluminal coronary angioplasty (p < 0.001). Six months after ELCA the mean diameter stenosis had increased to 60 ± 26% (p < 0.001). A ≥50% diameter stenosis was present in 48 patients (54%); in 24 of these patients diameter stenosis was ≥70%. Total occlusions occurred in an additional 10 patients (11%). There was a trend toward an increased recurrent restenosis rate in patients with diabetes mellitus and long lesions or total occlusions (p = 0.059). Forty-eight patients (50%) received medical treatment after six months. Reinterventions were necessary in 30 patients (31%), and coronary artery bypass surgery was performed in 17 patients (18%). Event-free survival was 50%.
CONCLUSIONS
Excimer laser angioplasty for in-stent restenosis was associated with a high incidence of recurrent restenosis in this group of patients, suggesting that this technique is unlikely to reduce recurrent in-stent restenosis and that other approaches are necessary.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>10898415</pmid><doi>10.1016/S0735-1097(00)00704-X</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0735-1097 |
ispartof | Journal of the American College of Cardiology, 2000-07, Vol.36 (1), p.69-74 |
issn | 0735-1097 1558-3597 |
language | eng |
recordid | cdi_proquest_miscellaneous_71234538 |
source | MEDLINE; Access via ScienceDirect (Elsevier); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
subjects | Adult Aged Angioplasty, Balloon, Coronary - methods Angioplasty, Balloon, Laser-Assisted Biological and medical sciences Coronary Angiography Coronary Disease - diagnostic imaging Coronary Disease - surgery Disease-Free Survival Diseases of the cardiovascular system Female Follow-Up Studies Humans Male Medical sciences Middle Aged Prevalence Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Recurrence Reoperation Stents Treatment Outcome |
title | Six-month clinical and angiographic outcome after successful excimer laser angioplasty for in-stent restenosis |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T22%3A39%3A35IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Six-month%20clinical%20and%20angiographic%20outcome%20after%20successful%20excimer%20laser%20angioplasty%20for%20in-stent%20restenosis&rft.jtitle=Journal%20of%20the%20American%20College%20of%20Cardiology&rft.au=K%C3%B6ster,%20Ralf&rft.date=2000-07-01&rft.volume=36&rft.issue=1&rft.spage=69&rft.epage=74&rft.pages=69-74&rft.issn=0735-1097&rft.eissn=1558-3597&rft.coden=JACCDI&rft_id=info:doi/10.1016/S0735-1097(00)00704-X&rft_dat=%3Cproquest_cross%3E71234538%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=71234538&rft_id=info:pmid/10898415&rft_els_id=S073510970000704X&rfr_iscdi=true |