Impact of cutting balloon angioplasty (CBA) prior to bare metalstenting on restenosis

• Ozaki Yukio

  Division of Cardiology, Fujita Health University Hospital

• Yamaguchi Tetsu

  Toranomon Hospital

• Suzuki Takahiko

  Toyohashi Heart Center

• Nakamura Masato

  Toho University Medical Center Ohashi Hospital

• Kitayama Michihiko

  Kanazawa Medical University

• Nishikawa Hideo

  Mie Heart Center, Meiwa, Japan & Yamada Red Cross Hospital

• Inoue Teruo

  Saga Medical University, Saga, Japan & Koshigaya Hospital, Dokkyo University, School of Medicine

• Hara Kazuhiro

  Mitsui Memorial Hospital

• Usuba Fumihiko

  Tomei Atsugi Clinic & Kikuna Memorial Hospital

• Sakurada Masami

  Tokorozawa Heart Center, Tokorozawa, Japan & Sekishinkai Sayama Hospital

• Awano Kojiro

  Miki City Hospital

• Matsuo Hitoshi

  Gifu Prefectural Gifu Hospital

• Ishiwata Sugao

  Toranomon Hospital

• Yasukawa Tatsuya

  Yasukawa Clinic & Aichi Medical University

• Ismail Tevfik F.

  Royal Brompton Hospital

• Hishida Hitoshi

  Division of Cardiology, Fujita Health University Hospital

• Kato Osamu

  Toyohashi Heart Center, Toyohashi & Kyoto Katsura Hospital

書誌事項

タイトル別名

• Impact of Cutting Balloon Angioplasty (CBA) Prior to Bare Metal Stenting on Restenosis A Prospective Randomized Multicenter Trial Comparing CBA With Balloon Angioplasty (BA) Before Stenting (REDUCE III)
• A Prospective Randomized Multicenter Trial Comparing CBA With Balloon Angioplasty (BA) Before Stenting (REDUCE III)

抄録

Background While stent restenosis and late thrombosis still occur even with drug-eluting-stents (DES), there remains a need to explore other strategies for preventing restenosis. Methods and Results Five hundred and twenty-one patients were randomized: 260 to cutting-balloon angioplasty (CBA) before bare-metal stent (CBA-BMS) and 261 to balloon-angioplasty (BA) before BMS (BA-BMS). Intravascular ultrasound (IVUS)-guided procedures were performed in 279 (54%) patients and angiographic guidance was used in the remainder. Minimal lumen diameter was significantly greater in CBA-BMS than BA-BMS (2.65±0.40 mm vs 2.52±0.4 mm, p<0.01) and % diameter stenosis (%DS)-post was less in CBA-BMS than BA-BMS (14.0±5.9% vs 16.3±6.8%, p<0.01). %DS-follow-up was subsequently less in CBA-BMS than BA-BMS (32.4±15.1% vs 35.4±15.3%, p<0.05) associated with lower rates of restenosis in CBA-BMS than BA-BMS (11.8% vs 19.6%, p<0.05) and less target lesion revascularization (TLR) in CBA-BMS than BA-BMS (9.6% vs 15.3%, p<0.05). Patients were divided into 4 groups based on the device used before stenting and IVUS use (IVUS-CBA-BMS: 137 patients; Angio-CBA-BMS: 123; IVUS-BA-BMS: 142; and Angio-BA-BMS: 119). At follow-up IVUS-CBA-BMS had a significantly lower restenosis rate (6.6%) than Angio-CBA-BMS (17.9%), IVUS-BA-BMS (19.8%) and Angio-BA-BMS (18.2%, p<0.05). Conclusions Restenosis and TLR were significantly lower in CBA-BMS than BA-BMS. This favorable outcome was achieved because of the lower restenosis rate conferred by the IVUS-guided-CBA-BMS strategy (6.6%). The restenosis rates obtained with this strategy were comparable to those achieved with DES. (Circ J 2007; 71: 1 - 8)<br>

収録刊行物

• Circulation Journal

  Circulation Journal 71 (1), 1-8, 2007

  一般社団法人 日本循環器学会

キーワード

• Bare metal stent (BMS)
• Cutting balloon angioplasty (CBA)
• Drug-eluting stent (DES)
• Intravascular ultrasound (IVUS)
• Late stent thrombosis (LST)
• Quantitative coronary angiography (QCA)

詳細情報

• CRID: 1390282680079665664
• NII論文ID: 110006151856
• NII書誌ID: AA11591968
• DOI: 10.1253/circj.71.1
• ISSN: 13474820
• ISSN: 13469843
• Web Site: http://www.jstage.jst.go.jp/article/circj/71/1/71_1_1/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2007190413
• 本文言語コード: en
• データソース種別:
  • JaLC
  • Crossref
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可