PMID- 11146517
OWN - NLM
STAT- MEDLINE
DCOM- 20010222
LR  - 20191104
IS  - 1522-1946 (Print)
IS  - 1522-1946 (Linking)
VI  - 52
IP  - 1
DP  - 2001 Jan
TI  - Clinical and angiographic outcome in the laser angioplasty for restenotic stents 
      (LARS) multicenter registry.
PG  - 24-34
AB  - In-stent restenosis (ISR), when treated with balloon angioplasty (PTCA) alone, 
      has an angiographic recurrence rate of 30%-85%. Ablating the hypertrophic 
      neointimal tissue prior to PTCA is an attractive alternative, yet the late 
      outcomes of such treatment have not been fully determined. This multicenter case 
      control study assessed the angiographic and clinical outcomes of 157 consecutive 
      procedures in 146 patients with ISR at nine institutions treated with either PTCA 
      alone (n = 64) or excimer laser assisted coronary angioplasty (ELCA, n = 93)) for 
      ISR. Demographics were similar except more unstable angina at presentation in 
      ELCA-treated patients (74.5% vs. 63.5%; P = 0.141). Lesions selected for ELCA 
      were longer (16.8 +/- 11.2 mm vs. 11.2 +/- 8.6 mm; P < 0.001), more complex 
      (ACC/AHA type C: 35.1% vs. 13.6%; P < 0.001), and with compromised antegrade flow 
      (TIMI flow < 3: 18.9% vs. 4.5%; P = 0.008) compared to PTCA-treated patients. 
      ELCA-treated patients had similar rate of procedural success [93 (98.9% vs. 62 
      (98.4%); P = 1.0] and major clinical complications [1 (1.1%) vs. 1 (1.6%); P = 
      1.0]. At 30 days, repeat target site coronary intervention was lower in 
      ELCA-treated patients (1.1% vs. 6.4% in PTCA-treated patients; P = 0.158), but 
      not significantly so. At 1 year, ELCA-treated patients had similar rate of major 
      cardiac events (39.1% vs. 45.2%; P = 0.456) and target lesion revascularization 
      (30.0% vs. 32.3%; P = 0.646). These data suggest that ELCA in patients with 
      complex in-stent restenosis is as safe and effective as balloon angioplasty 
      alone. Despite higher lesion complexity in ELCA-treated patients, no increase in 
      event rates was observed. Future studies should evaluate the relative benefit of 
      ELCA over PTCA alone for the prevention of symptom recurrence specifically in 
      patients with complex in-stent restenosis.
FAU - Giri, S
AU  - Giri S
AD  - Division of Cardiology, Brigham and Women's Hospital, Boston, Massachusetts 
      02215, USA.
FAU - Ito, S
AU  - Ito S
FAU - Lansky, A J
AU  - Lansky AJ
FAU - Mehran, R
AU  - Mehran R
FAU - Margolis, J
AU  - Margolis J
FAU - Gilmore, P
AU  - Gilmore P
FAU - Garratt, K N
AU  - Garratt KN
FAU - Cummins, F
AU  - Cummins F
FAU - Moses, J
AU  - Moses J
FAU - Rentrop, P
AU  - Rentrop P
FAU - Oesterle, S
AU  - Oesterle S
FAU - Power, J
AU  - Power J
FAU - Kent, K M
AU  - Kent KM
FAU - Satler, L F
AU  - Satler LF
FAU - Pichard, A D
AU  - Pichard AD
FAU - Wu, H
AU  - Wu H
FAU - Greenberg, A
AU  - Greenberg A
FAU - Bucher, T A
AU  - Bucher TA
FAU - Kerker, W
AU  - Kerker W
FAU - Abizaid, A S
AU  - Abizaid AS
FAU - Saucedo, J
AU  - Saucedo J
FAU - Leon, M B
AU  - Leon MB
FAU - Popma, J J
AU  - Popma JJ
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Catheter Cardiovasc Interv
JT  - Catheterization and cardiovascular interventions : official journal of the 
      Society for Cardiac Angiography & Interventions
JID - 100884139
SB  - IM
MH  - Aged
MH  - Angioplasty, Balloon, Coronary/*adverse effects/*instrumentation
MH  - Angioplasty, Laser/*methods
MH  - Chi-Square Distribution
MH  - Coronary Angiography
MH  - Coronary Disease/mortality/*surgery/therapy
MH  - Female
MH  - Follow-Up Studies
MH  - Graft Occlusion, Vascular/mortality/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multicenter Studies as Topic
MH  - Probability
MH  - Randomized Controlled Trials as Topic
MH  - Recurrence
MH  - Registries
MH  - Stents/*adverse effects
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 2001/01/09 11:00
MHDA- 2001/03/03 10:01
CRDT- 2001/01/09 11:00
PHST- 2001/01/09 11:00 [pubmed]
PHST- 2001/03/03 10:01 [medline]
PHST- 2001/01/09 11:00 [entrez]
AID - 10.1002/1522-726X(200101)52:1<24::AID-CCD1007>3.0.CO;2-Y [pii]
AID - 10.1002/1522-726x(200101)52:1<24::aid-ccd1007>3.0.co;2-y [doi]
PST - ppublish
SO  - Catheter Cardiovasc Interv. 2001 Jan;52(1):24-34. doi: 
      10.1002/1522-726x(200101)52:1<24::aid-ccd1007>3.0.co;2-y.