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Real-life experience of a stent-less revascularization strategy using a combination of excimer laser and drug-coated balloon for patients with acute coronary syndrome.
In: Journal of Interventional Cardiology, Jg. 31 (2018-06-01), Heft 3, S. 284-292
Online
academicJournal
Zugriff:
Objectives: We aimed to test a novel stent-less revascularization strategy using a combination of excimer laser coronary angioplasty (ELCA) and drug-coated balloon (DCB) for patients with acute coronary syndrome (ACS). Background: Percutaneous coronary intervention with drug eluting stents is a standard invasive treatment for ACS. Some unsolved issues however remain, such as stent thrombosis and bleeding risks associated with dual antiplatelet therapy. Methods: Consecutive ACS patients were planned to receive either a DCB application following ELCA without a stent implantation or conventional revascularization with a coronary stent. The endpoints were (i) major cardiac adverse events (MACEs), defined as the composite of cardiac death, myocardial infarctions, and target lesion revascularization; (ii) target vessel revascularization (TVR); and (iii) angiographic outcome. Results: Since a greater than expected number of patients allocated to the stent-less treatment arm eventually received a bailout stenting, the following 3 as-treated groups were compared; DCB with ELCA group (N = 60), Stent with ELCA group (N = 23), and Stent without ELCA group (N = 85). During a mean follow-up period of 420 ± 137 days, and with angiographic 6- and 12-month-follow-up rates of 96.7%, 87%, and 81.2%, and 50%, 65.2%, and 45.9%, respectively, the MACE rate did not differ across the groups (10%, 4.3%, and 3.5%; P = 0.22) while an incidence of TVR was more common (15%, 0, and 4.7%; P = 0.02) and the diameter stenosis at 6-months of follow-up was greater (25.7 ± 18.2, 14.9 ± 13.1 and 16.2 ± 15.4%; P = 0.002) in the DCB with ELCA group. Conclusions: The stent-less revascularization strategy with DCB and ELCA was associated with a higher occurrence of restenosis in ACS patients. [ABSTRACT FROM AUTHOR]
Titel: |
Real-life experience of a stent-less revascularization strategy using a combination of excimer laser and drug-coated balloon for patients with acute coronary syndrome.
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Autor/in / Beteiligte Person: | Harima, Ayako ; Sairaku, Akinori ; Inoue, Ichiro ; Nishioka, Kenji ; Oka, Toshiharu ; Nakama, Yasuharu ; Dai, Kazuoki ; Ohi, Kuniomi ; Hashimoto, Haruki ; Kihara, Yasuki |
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Zeitschrift: | Journal of Interventional Cardiology, Jg. 31 (2018-06-01), Heft 3, S. 284-292 |
Veröffentlichung: | 2018 |
Medientyp: | academicJournal |
ISSN: | 0896-4327 (print) |
DOI: | 10.1111/joic.12495 |
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