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Cutting balloon angioplasty vs. conventional balloon angioplasty in patients receiving intracoronary brachytherapy for the treatment of in-stent restenosis. Catheter Cardiovasc Interv 2004 Oct;63(2):152-7

Date

09/25/2004

Pubmed ID

15390249

DOI

10.1002/ccd.20123

Scopus ID

2-s2.0-4744355137   6 Citations

Abstract

The objective of this study was to evaluate the safety and efficacy of cutting balloon angioplasty (CBA) for the treatment of in-stent restenosis prior to intracoronary brachytherapy (ICB). Cutting balloon angioplasty may reduce the incidence of uncontrolled dissection requiring adjunctive stenting and may limit "melon seeding" and geographic miss in patients with in-stent restenosis who are subsequently treated with ICB. We performed a retrospective case-control analysis of 134 consecutive patients with in-stent restenosis who were treated with ICB preceded by either CBA or conventional balloon angioplasty. We identified 44 patients who underwent CBA and ICB, and 90 control patients who underwent conventional percutaneous transluminal coronary angioplasty (PTCA) and ICB for the treatment of in-stent restenosis. Adjunctive coronary stenting was performed in 13 patients (29.5%) in the CBA/ICB group and 41 patients (45.6%; P < 0.001) in the PTCA/ICB group. There was no difference in the injury length or active treatment (ICB) length. The procedural and angiographic success rates were similar in both groups. There were no statistically significant differences in the incidence of death, myocardial infarction, recurrent angina pectoris, subsequent target lumen revascularization, or the composite endpoint of all four clinical outcomes (P > 0.05). Despite sound theoretical reasons why CBA may be better than conventional balloon angioplasty for treatment of in-stent restenosis with ICB, and despite a reduction in the need for adjunctive coronary stenting, we were unable to identify differences in clinical outcome.

Author List

Fasseas P, Orford JL, Lennon R, O'Neill J, Denktas AE, Panetta CJ, Berger PB, Holmes DR

Author

Panayotis Fasseas MD Associate Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aged
Angioplasty, Balloon
Angioplasty, Balloon, Coronary
Brachytherapy
Case-Control Studies
Chi-Square Distribution
Combined Modality Therapy
Coronary Angiography
Coronary Restenosis
Female
Humans
Male
Middle Aged
Registries
Retrospective Studies
Statistics, Nonparametric
Stents
Treatment Outcome