Comparison of balloon angioplasty versus debulking devices versus stenting in right coronary ostial lesions

Jain, Suresh P.; Liu, Ming W.; Dean, Larry S.; Babu, Ramesh; Goods, C.; Yadav, Jay S.; Al-Shaibi, Khaled; Mathur, Atul; Iyer, Sriram S.; Parks, J.Michael; Baxley, William A.; Roubin, Gary S.

doi:10.1016/s0002-9149(97)00135-5

Cited by 49 publications

(19 citation statements)

References 17 publications

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“…In cases where lesions cannot be crossed or dilated, RA can result in greater acute gain and improvements in overall procedural success [41]. However, improvements to mid and long-term clinical outcomes have not been consistently demonstrated [42][43][44].…”

Section: Rotational Atherectomymentioning

confidence: 99%

Evaluation of the Diamondback 360 Coronary Orbital Atherectomy System for treatingde novo, severely calcified lesions

Chambers

Diage

2014

Expert Review of Medical Devices

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Section: Rotational Atherectomymentioning

confidence: 99%

Evaluation of the Diamondback 360 Coronary Orbital Atherectomy System for treatingde novo, severely calcified lesions

Chambers

Diage

2014

Expert Review of Medical Devices

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“…In the past, the clinical and angiographic outcomes after PCI to RCAos have been unacceptable after using various devices such as POBA, 7 BMS, [8][9][10][11] and debulking with a DCA 12 or a rotablator. 13 However, as the BX Velocity stent possesses potent radial force to scaffold the vascular wall, the SES (Cypher ® stent), in which sirolimus is eluted on the BX Velocity stent, was expected to ameliorate RCAos by combining the effect of the radial scaffolding force of the BX Velocity stent with sirolimus, which suppresses the growth of neointima.…”

Section: Circulation Journal Vol72 June 2008mentioning

confidence: 99%

“…[7][8][9][10][11][12][13] Furthermore, RCAos is reported to be the most powerful predictor for TLR after SES implantation, 3,4 although SES brings greater benefits for stenting to RCAos compared with BMS. 14,15 Therefore, in the present study, the angiographic and clinical outcomes after SES implantation to RCAos were retrospectively estimated.…”

mentioning

confidence: 99%

Angiographic and Clinical Outcomes After Sirolimus-Eluting Stent Implantation to De Novo Ostial Lesion of the Right Coronary Artery A Retrospective Study

Sakamoto

Ishikawa

Murata

et al. 2008

Circ J

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) has been widely deployed to various types of lesions because of its promising data about the markedly reduced incidence of target lesion revascularization (TLR) with in-stent restenosis (ISR) compared with that of conventional bare metal stents (BMS). 1,2 However, several predictors for ISR and TLR after SES implantation have been reported. 3,4 In addition, although the molecular mechanism of ISR after SES implantation has been well studied, 5 the optimal method for ISR inside SES has not been fully explored. 6 Therefore, complete revascularization against ischemic coronary diseases by percutaneous coronary intervention (PCI) has not been achieved despite the upcoming era of the drug-eluting stent (DES).Ostial lesion of the right coronary artery (RCAos; which is defined as the lesion being within 3 mm of the ostia) has been a limitation of PCI because of its high ratio of restenosis after using various devices before the availability of the DES. 7-13 Furthermore, RCAos is reported to be the most powerful predictor for TLR after SES implantation, 3,4 although SES brings greater benefits for stenting to RCAos compared with BMS. 14,15 Therefore, in the present study, the angiographic and clinical outcomes after SES implantation to RCAos were retrospectively estimated. For this purpose, binary in-stent restenosis and TLR after SES implantation to de novo RCAos were compared with those of BMS and also with those of post-SES implantation to the de novo RCA proximal (RCApro; which is defined as the lesion beyond 3 mm distal from the ostia). Methods Study PopulationThe SES was approved in August 2004 in Japan; hence, after obtaining informed consent, the SES was routinely deployed, as described in our previous reports. 4,16,17 Briefly, the SES was routinely implanted in patients unless there was a known malignancy, pre-surgical operation, severe anemia, and the existence of various social conditions. Thus, those patients with BMS enrolled in the present study had received their implants before SES technology was approved. The quantitative coronary angiogram (QCA) data of RCAos (SES-RCAos group, n=37) and RCApro (SES-RCApro Background Although ostial lesion (defined as being within 3 mm of the ostia) of the right coronary artery (RCAos) has been a limitation of percutaneous coronary intervention after using previous various devices, the angiographic and clinical outcomes after the deployment of a sirolimus-eluting stent (SES) to RCAos have not been fully estimated. Therefore, the incidences of binary restenosis (BR; % diameter stenosis at chronic phase ≤50) and target lesion revascularization (TLR) after SES to RCAos were retrospectively compared with those after SES to RCA proximal (RCApro) and those after bare metal stents (BMS) to RCAos. Methods and ResultsThe ratios of BR (18.9%) and TLR (13.5%) after SES to RCAos (n=37, mean follow-up interval of each group was 249 days) were significantly decreased compared with those of BMS to RCAos (41.7%, 36.1%, p<0.01, respectively) (n=36, 194 days), but were significantly in...

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“…Directional coronary atherectomy has been used successfully in proximal anterior descending lesions and bifurcation lesions (638). Rotational atherectomy successfully treats calcific and diffusely diseased coronary vessels (654) and ostial stenoses (655,656). Excimer laser has been used to treat diffuse disease (657).…”

Section: Evolution Of Technologiesmentioning

confidence: 99%

ACC/AHA/SCAI Practice Guidelines, February 21, 2006

Wilkins¹

2006

Circulation

349

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Comparison of balloon angioplasty versus debulking devices versus stenting in right coronary ostial lesions

Cited by 49 publications

References 17 publications

Evaluation of the Diamondback 360 Coronary Orbital Atherectomy System for treatingde novo, severely calcified lesions

Evaluation of the Diamondback 360 Coronary Orbital Atherectomy System for treatingde novo, severely calcified lesions

Angiographic and Clinical Outcomes After Sirolimus-Eluting Stent Implantation to De Novo Ostial Lesion of the Right Coronary Artery A Retrospective Study

ACC/AHA/SCAI Practice Guidelines, February 21, 2006

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