Article (Scientific journals)
A randomized comparison of the value of additional stenting after optimal balloon angioplasty for long coronary lesions: final results of the additional value of NIR stents for treatment of long coronary lesions (ADVANCE) study.
Serruys, Patrick W.; Foley, David P.; Suttorp, Martin Jan et al.
2002In Journal of the American College of Cardiology, 39 (3), p. 393-9
Peer Reviewed verified by ORBi
 

Files


Full Text
a randomized comparizon JACC 2002.pdf
Publisher postprint (121.66 kB)
Download

All documents in ORBi are protected by a user license.

Send to



Details



Keywords :
Aged; Angioplasty, Balloon, Coronary/instrumentation; Coronary Restenosis/etiology/radiography; Coronary Stenosis/complications/radiography/therapy; Creatine Kinase/blood; Creatine Kinase, MB Form; Equipment Safety; Female; Follow-Up Studies; Humans; Incidence; Isoenzymes/blood; Male; Middle Aged; Myocardial Infarction/blood/etiology/radiography; Prospective Studies; Prosthesis Implantation/instrumentation; Severity of Illness Index; Stents; Treatment Outcome
Abstract :
[en] OBJECTIVES: We sought to investigate the clinical benefit of additional stent implantation after achieving an optimal result of balloon angioplasty (BA) in long coronary lesions (>20 mm). BACKGROUND: Long coronary lesions are associated with increased early complications and late restenosis after BA. Stenting improves the early outcome, but stent restenosis is also related to both lesion length and stent length. METHODS: A total of 437 patients with a single native lesion 20 to 50 mm in length were included and underwent BA, using long balloons matched to lesion length and vessel diameter (balloon/artery ratio 1.1) to achieve a diameter stenosis (DS) <30% by on-line quantitative coronary angiography (QCA). "Bail-out stenting" was performed for flow-limiting dissections or >50% DS. Patients in whom an optimal BA result was achieved were randomized to additional stenting (using NIR stents) or no stenting. The primary end point was freedom from major adverse cardiac events (MACE) at nine months, and core laboratory QCA was performed on serial angiograms. RESULTS: Bailout stenting was necessary in 149 patients (34%) and was associated with a significantly increased risk of peri-procedural infarction (p < 0.02). Among the 288 randomized patients, the mean lesion length was 27+/-9 mm, and the vessel diameter was 2.78+/-0.52 mm. The procedural success rate was 90% for the 143 patients assigned to BA alone (control group), as compared with 93% in the 145 patients assigned to additional stenting (stent group), which resulted in a superior early minimal lumen diameter (0.54 mm, p < 0.001) and led to reduced angiographic restenosis (27% vs. 42%, p = 0.022). Freedom from MACE at nine months was 77% in both groups. CONCLUSIONS: A strategy of provisional stenting for long coronary lesions led to bailout stenting in one-third of patients, with a threefold increase in peri-procedural infarction. Additional stenting yielded a lower angiographic restenosis rate, but no reduction in MACE at nine months.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Serruys, Patrick W.
Foley, David P.
Suttorp, Martin Jan
Rensing, Benno J. W. M.
Suryapranata, Harry
Materne, Phillipe
van den Bos, Arijan
Benit, Edouard
Anzuini, Angelo
Rutsch, Wolfgang
Legrand, Victor ;  Université de Liège - ULiège > Département des sciences cliniques > Cardiologie
Dawkins, Keith
Cobaugh, Michael
Bressers, Marco
Backx, Bianca
Wijns, William
Colombo, Antonio
More authors (7 more) Less
Language :
English
Title :
A randomized comparison of the value of additional stenting after optimal balloon angioplasty for long coronary lesions: final results of the additional value of NIR stents for treatment of long coronary lesions (ADVANCE) study.
Publication date :
2002
Journal title :
Journal of the American College of Cardiology
ISSN :
0735-1097
eISSN :
1558-3597
Publisher :
Elsevier, Netherlands
Volume :
39
Issue :
3
Pages :
393-9
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 31 May 2014

Statistics


Number of views
32 (2 by ULiège)
Number of downloads
187 (1 by ULiège)

Scopus citations®
 
88
Scopus citations®
without self-citations
73
OpenCitations
 
67

Bibliography


Similar publications



Contact ORBi