This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Batyraliev, T. A. Search for Related Content PubMed PubMed Citation Articles by Batyraliev, T. A. Pubmed/NCBI databases Medline Plus Health Information Angioplasty Social Bookmarking                         What's this?

Current Role of Laser Angioplasty of Restenotic Coronary Stents

Sani Konukoglu Medical Center, Gaziantep, Turkey

Igor V. Pershukov, MD, PhD, FACA

Regional Clinical Hospital, Voronezh, Russia, pershukov{at}yahoo.co.uk

Zarema A. Niyazova-Karben, MD, PhD, FACA

Sani Konukoglu Medical Center, Gaziantep, Turkey

Alexandru Karaus, MD, PhD

Cardiology Institute, Kishineu, Moldova

Oleg Calenici, MD, PhD

Cardiology Institute, Kishineu, Moldova

Niyazi Guler, MD, PhD

Yuzuncu Yil University, Van, Turkey

Beyhan Eryonucu, MD, PhD

Yuzuncu Yil University, Van, Turkey

Alivahit Temamogullari, MD

SSK Hospital, Urfa, Turkey, the Government Hospital, Maras, Turkey

Sami Ozgul, MD, PhD

University Clinical Hospital, Antakya, Turkey

Ferit Akgul, MD

University Clinical Hospital, Antakya, Turkey

Hakan Sengul, MD

Sani Konukoglu Medical Center, Gaziantep, Turkey

Orhan Dogru, MD

Sani Konukoglu Medical Center, Gaziantep, Turkey

Onder Demirbas, MD

Sani Konukoglu Medical Center, Gaziantep, Turkey

Ivan S. Timoshin, MD

Regional Clinical Hospital, Voronezh, Russia

Alexei V. Gaigukov, MD

Regional Clinical Hospital, Voronezh, Russia

Larisa N. Petrakova, MD

Presidential Medical Center Central Clinical Hospital, Moscow, Russia

Marina K. Peresypko, MD

Presidential Medical Center Central Clinical Hospital, Moscow, Russia

Boris A. Sidorenko, MD, PhD

Presidential Medical Center Central Clinical Hospital, Moscow, Russia

International Invasive Cardiology Research Group

Treatment of in-stent restenosis (ISR) with conventional percutaneous transluminal coronary angioplasty (PTCA) causes significant recurrent neointimal tissue growth in 30-85%. Therefore, laser ablation of intrastent neointimal hyperplasia before balloon dilation can be an attractive alternative. However, the long-term outcomes of such treatment have not been studied thoroughly enough. This prospective case-control study evaluated angiographic and clinical outcomes of PTCA alone and a combination of excimer laser coronary angioplasty (ELCA) and adjunct PTCA in 125 patients with ISR. ELCA was performed before balloon dilation in 67 patients, PTCA alone was performed in 58 patients. Basic demographic and clinical data were comparable in both groups. Lesions included in ELCA group were longer (17.1 ±9.9 vs 13.6 ±9.1 mm; p=0.034), more complex (36.5% type C stenoses vs 14.3%; p=0.006), and more frequently had reduced distal blood flow (TIMI <3: 18.9% vs 4.8%; p=0.025) compared to lesions in the PTCA group. Immediate angiographic results of PTCA and ELCA + PTCA appeared to be comparable. PTCA alone was successful in 57 patients (98.3%), ELCA + PTCA, in 66 patients (98.5%). The rates of hospital complications were comparable (3.0% in ELCA group vs 8.6% in PTCA group). The 1-year follow-up showed that the rates of major adverse cardiac events (MACE) were comparable in the 2 groups (37.3% in ELCA group vs 46.6% in PTCA group). The rates of target vessel revascularization (TVR) within 1 year after the intervention were also similar in the 2 groups (32.8% vs 34.5%). The data mean that ELCA in patients with complex ISR is efficient and safe. Despite a higher complexity of lesions in the ELCA group, no increase in the rate of complications was registered.

Angiology, Vol. 57, No. 1, 21-32 (2006)
DOI: 10.1177/000331970605700104


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?