Randomized comparison of primary stenting and provisional balloon angioplasty guided by flow velocity measurement
| Autor: | Nico H.J. Pijls, Vasilis Voudris, Jorge Belardi, Patrick W. Serruys, Olivier Gurné, Gerrit Anne van Es, Ben A. van Hout, Ian Simpson, Bernard De Bruyne, José Eduardo Moraes Rego Sousa, Toshiya Muramatsu, Chris J. Vrints, Marie Angèle Morel, Stephane Carlier, Peter Probst, Jan J. Piek, Ricardo Seabra-Gomes, Eric Boersma |
|---|---|
| Přispěvatelé: | Cardiology |
| Jazyk: | angličtina |
| Rok vydání: | 2000 |
| Předmět: |
medicine.medical_specialty
Randomization medicine.diagnostic_test business.industry medicine.medical_treatment Event free survival Angioplasty Cost-benefit analysis Random allocation Stent Balloon equipment and supplies Surgery Doppler flow Physiology (medical) Diameter stenosis Angiography medicine Stents Radiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | Circulation, 102, 2930-2937. Lippincott Williams & Wilkins Circulation, 102(24), 2930-2937. Lippincott Williams and Wilkins Ltd. |
| ISSN: | 0009-7322 |
| Popis: | Background —Coronary stenting improves outcomes compared with balloon angioplasty, but it is costly and may have other disadvantages. Limiting stent use to patients with a suboptimal result after angioplasty (provisional angioplasty) may be as effective and less expensive. Methods and Results —To analyze the cost-effectiveness of provisional angioplasty, patients scheduled for single-vessel angioplasty were first randomized to receive primary stenting (97 patients) or balloon angioplasty guided by Doppler flow velocity and angiography (523 patients). Patients in the latter group were further randomized after optimization to either additional stenting or termination of the procedure to further investigate what is “optimal.” An optimal result was defined as a flow reserve >2.5 and a diameter stenosis P =0.014). Results after the second randomization showed that stenting was also more effective after optimal balloon angioplasty (1-year event free survival, 93.5% versus 84.1%; P =0.066). Conclusions —After 1 year of follow-up, provisional angioplasty was more expensive and without clinical benefit. The beneficial value of stenting is not limited to patients with a suboptimal result after balloon angioplasty. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|