BACKGROUND: Drug-eluting stents (DES) are superior to bare metal stents (BMS) for treating ostial left anterior descending artery (LAD) lesions, but DES is not suitable for all patients in real life practice. HYPOTHESIS: We hypothesize that cutting balloon angioplasty (CBA) followed by BMS (CBA + BMS) for treating ostial LAD lesions is an alternative strategy. METHODS: In our study, 101 consecutive patients (51 with DES and 50 with CBA + BMS) with ostial LAD stenting were included for retrospective investigation between November 2003 and May 2005. The target vessel diameter was > or =3.0 mm. RESULTS: We compared the DES group with the CBA + BMS group, the rates of restenosis (10.3% versus 17.9%, p = 0.386), target lesion revascularization (TLR) (5.88% versus 10%, p = 0.487) and major adverse cardiac events (MACE) (7.84% versus 12%, p = 0.525) were similar at 6-8 months angiographic follow-up, but there were higher bleeding events in the DES group (p = 0.033). During a 2-year clinical follow-up, no myocardial infarction occurred in the 2 groups, the rates of TLR (7.84% versus 10%, p = 0.741) and MACE (9.8% versus 12%, p = 0.723) were also similar. The MACE-free survival rate was 90.2% versus 88 % (p = 0.723). CONCLUSIONS: The CBA + BMS combination has a good long-term clinical effect in the treatment of ostial LAD lesions; it might be an alternative strategy for patients with contraindication for DES implantation, or patients who cannot endure long-term dual antiplatelet medication, or in elderly patients.
BACKGROUND: Drug-eluting stents (DES) are superior to bare metal stents (BMS) for treating ostial left anterior descending artery (LAD) lesions, but DES is not suitable for all patients in real life practice. HYPOTHESIS: We hypothesize that cutting balloon angioplasty (CBA) followed by BMS (CBA + BMS) for treating ostial LAD lesions is an alternative strategy. METHODS: In our study, 101 consecutive patients (51 with DES and 50 with CBA + BMS) with ostial LAD stenting were included for retrospective investigation between November 2003 and May 2005. The target vessel diameter was > or =3.0 mm. RESULTS: We compared the DES group with the CBA + BMS group, the rates of restenosis (10.3% versus 17.9%, p = 0.386), target lesion revascularization (TLR) (5.88% versus 10%, p = 0.487) and major adverse cardiac events (MACE) (7.84% versus 12%, p = 0.525) were similar at 6-8 months angiographic follow-up, but there were higher bleeding events in the DES group (p = 0.033). During a 2-year clinical follow-up, no myocardial infarction occurred in the 2 groups, the rates of TLR (7.84% versus 10%, p = 0.741) and MACE (9.8% versus 12%, p = 0.723) were also similar. The MACE-free survival rate was 90.2% versus 88 % (p = 0.723). CONCLUSIONS: The CBA + BMS combination has a good long-term clinical effect in the treatment of ostial LAD lesions; it might be an alternative strategy for patients with contraindication for DES implantation, or patients who cannot endure long-term dual antiplatelet medication, or in elderly patients.
Authors: Laura Mauri; Wen-hua Hsieh; Joseph M Massaro; Kalon K L Ho; Ralph D'Agostino; Donald E Cutlip Journal: N Engl J Med Date: 2007-02-12 Impact factor: 91.245
Authors: Matthias Pfisterer; Hans Peter Brunner-La Rocca; Peter T Buser; Peter Rickenbacher; Patrick Hunziker; Christian Mueller; Raban Jeger; Franziska Bader; Stefan Osswald; Christoph Kaiser Journal: J Am Coll Cardiol Date: 2006-11-02 Impact factor: 24.094
Authors: Gregg W Stone; Stephen G Ellis; David A Cox; James Hermiller; Charles O'Shaughnessy; James Tift Mann; Mark Turco; Ronald Caputo; Patrick Bergin; Joel Greenberg; Jeffrey J Popma; Mary E Russell Journal: N Engl J Med Date: 2004-01-15 Impact factor: 91.245
Authors: Jeffrey W Moses; Martin B Leon; Jeffrey J Popma; Peter J Fitzgerald; David R Holmes; Charles O'Shaughnessy; Ronald P Caputo; Dean J Kereiakes; David O Williams; Paul S Teirstein; Judith L Jaeger; Richard E Kuntz Journal: N Engl J Med Date: 2003-10-02 Impact factor: 91.245