A Comparison of Directional Atherectomy with Coronary Angioplasty in Patients with Coronary Artery Disease
Eric J. Topol, Ferdinand Leya, Cass A. Pinkerton, Patrick L. Whitlow, Berthold Hofling, Charles A. Simonton, Ronald R. Masden, Patrick W. Serruys, Martin B. Leon, David O. Williams, Spencer B. King, Daniel B. Mark, Jeffrey M. Isner, David R. Holmes, Stephen G. Ellis, Kerry L. Lee, Gordon P. Keeler, Lisa G. Berdan, Tomoaki Hinohara, Robert M. Califf, for The CAVEAT Study Group
Background Directional coronary atherectomy is a new techniqueof coronary revascularization by which atherosclerotic plaqueis excised and retrieved from target lesions. With respect tothe rate of restenosis and clinical outcomes, it is not knownhow this procedure compares with balloon angioplasty, whichrelies on dilation of the plaque and vessel wall. We comparedthe rate of restenosis after angioplasty with that after atherectomy.
Methods At 35 sites in the United States and Europe, 1012 patientswere randomly assigned to either atherectomy (512 patients)or angioplasty (500 patients). The patients underwent coronaryangiography at base line and again after six months; the pairedangiograms were quantitatively assessed at one laboratory byinvestigators unaware of the treatment assignments.
Results Stenosis was reduced to 50 percent or less more oftenwith atherectomy than with angioplasty (89 percent vs. 80 percent,P<0.001), and there was a greater immediate increase in vesselcaliber (1.05 vs. 0.86 mm, P<0.001). This was accompaniedby a higher rate of early complications (11 percent vs. 5 percent,P<0.001) and higher in-hospital costs ($11,904 vs. $10,637;P = 0.006). At six months, the rate of restenosis was 50 percentfor atherectomy and 57 percent for angioplasty (P = 0.06). However,the probability of death or myocardial infarction within sixmonths was higher in the atherectomy group (8.6 percent vs.4.6 percent, P = 0.007).
Conclusions Removing coronary artery plaque with atherectomyled to a larger luminal diameter and a small reduction in angiographicrestenosis, the latter being confined largely to the proximalleft anterior descending coronary artery. However, atherectomyled to a higher rate of early complications, increased cost,and no apparent clinical benefit after six months of follow-up.
Source Information
From the Cleveland Clinic Foundation, Cleveland (E.J.T., P.L.W., S.G.E.); Loyola Medical Center, Chicago (F.L.); St. Vincent's Hospital, Indianapolis (C.A.P.); Klinikum Grosshadern der Universitat, Munich, Germany (B.H.); Carolina's Medical Center, Charlotte, N.(C.A.S.); Jewish Hospital, Louisville, Ky. (R.R.M.); Erasmus University, Rotterdam, the Netherlands (P.W.S.); Washington Cardiology Center, Washington, D.(M.B.L.); Rhode Island Hospital, Providence (D.O.W.); Emory University Hospital, Atlanta (S.B.K.); Duke University Medical Center, Durham, N.(D.B.M., K.L.L., G.P.K., L.G.B., R.M.C.); St. Elizabeth's Hospital, Boston (J.M.I.); Mayo Foundation, Rochester, Minn. (D.R.H.); and Sequoia Hospital, Redwood City, Calif. (T.H.). The remaining Coronary Angioplasty versus Excisional Atherectomy Trial (CAVEAT) investigators and study groups are listed in the Appendix.
Address reprint requests to Dr. Topol at the Department of Cardiology, Cleveland Clinic Foundation, Desk F25, 9500 Euclid Ave., Cleveland, OH 44195.
Clinical Problem-Solving: Invasive Interventions
Kern M. J., Bach R. G., Kallfelz M. L. d. A., Degrazia R. C., Rashdan I., Tolchin D., Anía B. J., Cárdenes M. A., Pauker S. G., Kopelman R. I.
Extract |
Full Text
N Engl J Med 1995;
332:125-127, Jan 12, 1995.
Correspondence
This article has been cited by other articles:
Newsome, L. T., Kutcher, M. A., Royster, R. L.
(2008). Coronary Artery Stents: Part I. Evolution of Percutaneous Coronary Intervention. Anesth. Analg.
107: 552-569
[Abstract][Full Text]
Pocock, S. J., Lansky, A. J., Mehran, R., Popma, J. J., Fahy, M. P., Na, Y., Dangas, G., Moses, J. W., Pucelikova, T., Kandzari, D. E., Ellis, S. G., Leon, M. B., Stone, G. W.
(2008). Angiographic surrogate end points in drug-eluting stent trials: a systematic evaluation based on individual patient data from 11 randomized, controlled trials.. J Am Coll Cardiol
51: 23-32
[Abstract][Full Text]
Wilson, J. M., Willerson, J. T.
(2008). Myocardial Revascularization with Percutaneous Devices. Card Surg Adult
3: 573-598
[Full Text]
Ilkay, E., Tirikli, L., Ozercan, I., Yavuzkir, M., Karaca, I., Rahman, A., Arslan, N.
(2006). Oral Mycophenolate Mofetil Prevents In-Stent Intimal Hyperplasia Without Edge Effect. ANGIOLOGY
57: 577-584
[Abstract]
Smith, P. K., Califf, R. M., Tuttle, R. H., Shaw, L. K., Lee, K. L., Delong, E. R., Lilly, R. E., Sketch, M. H. Jr, Peterson, E. D., Jones, R. H.
(2006). Selection of surgical or percutaneous coronary intervention provides differential longevity benefit.. Ann. Thorac. Surg.
82: 1420-1429
[Abstract][Full Text]
Bahrmann, P, Figulla, H R, Wagner, M, Ferrari, M, Voss, A, Werner, G S
(2005). Detection of coronary microembolisation by Doppler ultrasound during percutaneous coronary interventions. Heart
91: 1186-1192
[Abstract][Full Text]
Bhatt, D. L., Topol, E. J.
(2005). Periprocedural Cardiac Enzyme Elevation Predicts Adverse Outcomes. Circulation
112: 906-922
[Full Text]
Authors/Task Force Members, , Silber, S., Albertsson, P., Aviles, F. F., Camici, P. G., Colombo, A., Hamm, C., Jorgensen, E., Marco, J., Nordrehaug, J.-E., Ruzyllo, W., Urban, P., Stone, G. W., Wijns, W.
(2005). Guidelines for Percutaneous Coronary Interventions: The Task Force for Percutaneous Coronary Interventions of the European Society of Cardiology. Eur Heart J
26: 804-847
[Full Text]
Briguori, C., Colombo, A., Airoldi, F., Violante, A., Focaccio, A., Balestrieri, P., Paolo Elia, P., Golia, B., Lepore, S., Riviezzo, G., Scarpato, P., Librera, M., Bonizzoni, E., Ricciardelli, B.
(2004). Statin administration before percutaneous coronary intervention: impact on periprocedural myocardial infarction. Eur Heart J
25: 1822-1828
[Abstract][Full Text]
Bittl, J. A., Chew, D. P., Topol, E. J., Kong, D. F., Califf, R. M.
(2004). Meta-Analysis of randomized trials of percutaneous transluminal coronary angioplasty versus atherectomy, cutting balloon atherotomy, or laser angioplasty. J Am Coll Cardiol
43: 936-942
[Abstract][Full Text]
Holmes, D. R. Jr, Leon, M. B., Moses, J. W., Popma, J. J., Cutlip, D., Fitzgerald, P. J., Brown, C., Fischell, T., Wong, S. C., Midei, M., Snead, D., Kuntz, R. E.
(2004). Analysis of 1-Year Clinical Outcomes in the SIRIUS Trial: A Randomized Trial of a Sirolimus-Eluting Stent Versus a Standard Stent in Patients at High Risk for Coronary Restenosis. Circulation
109: 634-640
[Abstract][Full Text]
Medina, L. S., Aguirre, E., Bernal, B., Altman, N. R.
(2004). Functional MR Imaging versus Wada Test for Evaluation of Language Lateralization: Cost Analysis. Radiology
230: 49-54
[Abstract][Full Text]
Khot, U. N., Khot, M. B., Bajzer, C. T., Sapp, S. K., Ohman, E. M., Brener, S. J., Ellis, S. G., Lincoff, A. M., Topol, E. J.
(2003). Prevalence of Conventional Risk Factors in Patients With Coronary Heart Disease. JAMA
290: 898-904
[Abstract][Full Text]
Gomma, A.H., Elrayess, M.A., Knight, C.J., Hawe, E., Fox, K.M., Humphries, S.E.
(2002). The endothelial nitric oxide synthase (Glu298Asp and -786T>C) gene polymorphisms are associated with coronary in-stent restenosis. Eur Heart J
23: 1955-1962
[Abstract]
Bourassa, M.G, Detre, K.M, Johnston, J.M, Vlachos, H.A, Holubkov, R
(2002). Effect of prior revascularization on outcome following percutaneous coronary intervention. NHLBI Dynamic Registry. Eur Heart J
23: 1546-1555
[Abstract][Full Text]
Van Belle, E., Perie, M., Braune, D., Chmait, A., Meurice, T., Abolmaali, K., McFadden, E. P., Bauters, C., Lablanche, J.-M., Bertrand, M. E.
(2002). effects of coronary stenting on vessel patency and long-term clinical outcome after percutaneous coronary revascularization in diabetic patients. J Am Coll Cardiol
40: 410-417
[Abstract][Full Text]
Morice, M.-C., Serruys, P. W., Sousa, J. E., Fajadet, J., Ban Hayashi, E., Perin, M., Colombo, A., Schuler, G., Barragan, P., Guagliumi, G., Molnar, F., Falotico, R., the RAVEL Study Group,
(2002). A Randomized Comparison of a Sirolimus-Eluting Stent with a Standard Stent for Coronary Revascularization. NEJM
346: 1773-1780
[Abstract][Full Text]
Fihn, S. D., Williams, S. V., Daley, J., Gibbons, R. J.
(2001). Guidelines for the Management of Patients with Chronic Stable Angina: Treatment. ANN INTERN MED
135: 616-632
[Abstract][Full Text]
Singh, M., Reeder, G. S., Ohman, E. M., Mathew, V., Hillegass, W. B., Anderson, R. D., Gallup, D. S., Garratt, K. N., Holmes, D. R. Jr
(2001). Does the presence of thrombus seen on a coronary angiogram affect the outcome after percutaneous coronary angioplasty? An angiographic trials pool data experience. J Am Coll Cardiol
38: 624-630
[Abstract][Full Text]
Berk, B. C.
(2001). Vascular Smooth Muscle Growth: Autocrine Growth Mechanisms. Physiol. Rev.
81: 999-1030
[Abstract][Full Text]
Smith, S. C. Jr, Dove, J. T., Jacobs, A. K., Ward Kennedy, J., Kereiakes, D., Kern, M. J., Kuntz, R. E., Popma, J. J., Schaff, H. V., Williams, D. O., Gibbons, R. J., Alpert, J. P., Eagle, K. A., Faxon, D. P., Fuster, V., Gardner, T. J., Gregoratos, G., Russell, R. O., Smith, S. C. Jr
(2001). ACC/AHA guidelines for percutaneous coronary intervention (revision of the 1993 PTCA guidelines): A report of the American College of Cardiology/ American Heart Association Task Force on practice guidelines (Committee to revise the 1993 guidelines for percutaneous transluminal coronary angioplasty) endorsed by the Society for Cardiac Angiography and Interventions. J Am Coll Cardiol
37: 2239-2239
[Full Text]
Cantor, W. J., Hellkamp, A. S., Peterson, E. D., Zidar, J. P., Cowper, P. A., Sketch, M. H. Jr, Tcheng, J. E., Califf, R. M., Ohman, E. M.
(2001). Achieving optimal results with standard balloon angioplasty: can baseline and angiographic variables predict stent-like outcomes?. J Am Coll Cardiol
37: 1883-1890
[Abstract][Full Text]
Yamasaki, Y., Miyoshi, K., Oda, N., Watanabe, M., Miyake, H., Chan, J., Wang, X., Sun, L., Tang, C., McMahon, G., Lipson, K. E.
(2001). Weekly Dosing With the Platelet-Derived Growth Factor Receptor Tyrosine Kinase Inhibitor SU9518 Significantly Inhibits Arterial Stenosis. Circ. Res.
88: 630-636
[Abstract][Full Text]
Topol, E. J., Nurok, M., Ratain, M. J., Sheridan, M. E., Lo, B., Wolf, L., McCrary, S. V., McCullough, L. B., Brody, B. A., Martin, J. B., Kasper, D. L.
(2001). Conflict-of-Interest Policies. NEJM
344: 1017-1018
[Full Text]
Hopp, H.-W., Baer, F. M., Ozbek, C., Kuck, K. H., Scheller, B., for the AtheroLink Study Group,
(2000). A synergistic approach to optimal stenting: Directional coronary atherectomy prior to coronary artery stent implantation--the AtheroLink registry. J Am Coll Cardiol
36: 1853-1859
[Abstract][Full Text]
Otsuka, Y, Miyazaki, S, Okumura, H, Yasuda, S, Daikoku, S, Morii, I, Sutani, Y, Goto, Y, Nonogi, H
(2000). Abnormal glucose tolerance, not small vessel diameter, is a determinant of long-term prognosis in patients treated with balloon coronary angioplasty. Eur Heart J
21: 1790-1796
[Abstract]
Lincoff, A.M., Topol, E.J.
(2000). Platelet glycoprotein IIb/IIIa inhibition during percutaneous coronary revascularization: what more needs to be proven?. Eur Heart J
21: 863-867
Hundley, W. G., Hillis, L. D., Hamilton, C. A., Applegate, R. J., Herrington, D. M., Clarke, G. D., Braden, G. A., Thomas, M. S., Lange, R. A., Peshock, R. M., Link, K. M.
(2000). Assessment of Coronary Arterial Restenosis With Phase-Contrast Magnetic Resonance Imaging Measurements of Coronary Flow Reserve. Circulation
101: 2375-2381
[Abstract][Full Text]
Ogawa, I., Hayashi, T., Nakabayashi, T., Otani, N., Ishikawa, K., Kanamasa, K.
(2000). Prevention of Coronary Arterial Renarrowing by Continuous 3-Day Infusion of Tissue Plasminogen Activator After Successful Percutaneous Transluminal Coronary Angioplasty: A Randomized, Double-Blind, Placebo-Controlled Study. ANGIOLOGY
51: 367-375
[Abstract]
Serruys, P. W., Foley, D. P., Hofling, B., Puel, J., Glogar, H. D., Seabra-Gomes, R., Goicolea, J., Coste, P., Rutsch, W., Katus, H., Bonnier, H., Wijns, W., Betriu, A., Hauf-Zachariou, U., van Swijndregt, E. M., Melkert, R., Simon, R.
(2000). Carvedilol for Prevention of Restenosis After Directional Coronary Atherectomy : Final Results of the European Carvedilol Atherectomy Restenosis (EUROCARE) Trial. Circulation
101: 1512-1518
[Abstract][Full Text]
Emanuelsson, H.
(2000). Stents, antithrombotic agents and vascular complications. Does site of arterial access make a difference?. Eur Heart J
21: 607-609
Rubin, G. D., Armerding, M. D., Dake, M. D., Napel, S.
(2000). Cost Identification of Abdominal Aortic Aneurysm Imaging by Using Time and Motion Analyses. Radiology
215: 63-70
[Abstract][Full Text]
Bruce, C. J., Kuntz, R. E., Popma, J. J., Pieper, K. S., Topol, E. J., Holmes, D. R. Jr.
(2000). Application of a continuous regression model of restenosis to saphenous vein grafts after successful percutaneous transluminal coronary angioplasty or directional coronary atherectomy. J Am Coll Cardiol
35: 619-623
[Abstract][Full Text]
Topol, E. J., Yadav, J. S.
(2000). Recognition of the Importance of Embolization in Atherosclerotic Vascular Disease. Circulation
101: 570-580
[Full Text]
von Birgelen, C, Mintz, G S, de Vrey, E A, Serruys, P W, Kimura, T, Nobuyoshi, M, Popma, J J, Leon, M B, Erbel, R, de Feyter, P J
(2000). Preintervention lesion remodelling affects operative mechanisms of balloon optimised directional coronary atherectomy procedures: a volumetric study with three dimensional intravascular ultrasound. Heart
83: 192-197
[Abstract][Full Text]
van Liebergen, R. A. M., Piek, J. J., Koch, K. T., Peters, R. J. G., de Winter, R. J., Schotborgh, C. E., Lie, K. I.
(1999). Hyperemic coronary flow after optimized intravascular ultrasound-guided balloon angioplasty and stent implantation. J Am Coll Cardiol
34: 1899-1906
[Abstract][Full Text]
Betriu, A., Masotti, M., Serra, A., Alonso, J., Fernandez-Aviles, F., Gimeno, F., Colman, T., Zueco, J., Delcan, J. L., Garcia, E., Calabuig, J.
(1999). Randomized comparison of coronary stent implantation and balloon angioplasty in the treatment of de novo coronary artery lesions (START): A four-year follow-up. J Am Coll Cardiol
34: 1498-1506
[Abstract][Full Text]
Shennib, H.
(1999). Tools for precision enhancement in minimally invasive cardiac surgery: three dimensional visualization, computer enhancement and robotics. Eur. J. Cardiothorac. Surg.
16: S93-S96
[Abstract][Full Text]
Suzuki, T., Hosokawa, H., Katoh, O., Fujita, T., Ueno, K., Takase, S., Fujii, K., Tamai, H., Aizawa, T., Yamaguchi, T., Kurogane, H., Kijima, M., Oda, H., Tsuchikane, E., Hinohara, T., Fitzgerald, P. J., for the ABACAS Investigators,
(1999). Effects of adjunctive balloon angioplasty after intravascular ultrasound-guided optimal directional coronary atherectomy: The result of adjunctive balloon angioplasty after coronary atherectomy study (ABACAS). J Am Coll Cardiol
34: 1028-1035
[Abstract][Full Text]
Tsuchikane, E., Sumitsuji, S., Awata, N., Nakamura, T., Kobayashi, T., Izumi, M., Otsuji, S., Tateyama, H., Sakurai, M., Kobayashi, T.
(1999). Final results of the STent versus directional coronary Atherectomy Randomized Trial (START). J Am Coll Cardiol
34: 1050-1057
[Abstract][Full Text]
Windecker, S., Maier-Rudolph, W., Bonzel, T., Heyndrickx, G., Lablanche, J.M., Morice, M.C., Muhlberger, V., Neuhaus, K.L., Piscione, F., van den Brand, M., Wijns, W., Meier, B., Working Group Coronary Circulation of the European,
(1999). Interventional cardiology in Europe 1995. Eur Heart J
20: 484-495
[Abstract]
Bertrand, M. E., Bauters, C.
(1999). Cytomegalovirus Infection and Coronary Restenosis. Circulation
99: 1278-1279
[Full Text]
Manegold, C., Alwazzeh, M., Jablonowski, H., Adams, O., Medve, M., Seidlitz, B., Heidland, U., Haussinger, D., Strauer, B.-E., Heintzen, M. P.
(1999). Prior Cytomegalovirus Infection and the Risk of Restenosis After Percutaneous Transluminal Coronary Balloon Angioplasty. Circulation
99: 1290-1294
[Abstract][Full Text]
Numaguchi, Y., Naruse, K., Harada, M., Osanai, H., Mokuno, S., Murase, K., Matsui, H., Toki, Y., Ito, T., Okumura, K., Hayakawa, T.
(1999). Prostacyclin Synthase Gene Transfer Accelerates Reendothelialization and Inhibits Neointimal Formation in Rat Carotid Arteries After Balloon Injury. Arterioscler. Thromb. Vasc. Bio.
19: 727-733
[Abstract][Full Text]
Dauerman, H. L., Higgins, P. J., Sparano, A. M., Gibson, C. M., Garber, G. R., Carrozza, J. P. Jr., Kuntz, R. E., Laham, R. J., Shubrooks, S. J. Jr., Baim, D. S., Cohen, D. J.
(1998). Mechanical debulking versus balloon angioplasty for the treatment of true bifurcation lesions. J Am Coll Cardiol
32: 1845-1852
[Abstract][Full Text]
Bramucci, E., Angoli, L., Merlini, P. A., Barberis, P., Laudisa, M. L., Colombi, E., Poli, A., Kubica, J., Ardissino, D.
(1998). Adjunctive stent implantation following directional coronary atherectomy in patients with coronary artery disease. J Am Coll Cardiol
32: 1855-1860
[Abstract][Full Text]
de Vrey, E. A., Mintz, G. S., von Birgelen, C., Kimura, T., Noboyoshi, M., Popma, J. J., Serruys, P. W., Leon, M. B.
(1998). Serial volumetric (three-dimensional) intravascular ultrasound analysis of restenosis after directional coronary atherectomy. J Am Coll Cardiol
32: 1874-1880
[Abstract][Full Text]
Topol, E. J., Serruys, P. W.
(1998). Frontiers in Interventional Cardiology. Circulation
98: 1802-1820
[Full Text]
Goldberg, S., Aji, J.
(1998). Plaque Excision Combined With Stent Placement : Can a Poor "Finisher" Become a Good "Starter"?. Circulation
98: 1591-1593
[Full Text]
Anderson, R. D., Ohman, E. M., Holmes, D. R. Jr., Harrington, R. A., Barsness, G. W., Wildermann, N. M., Phillips, H. R., Topol, E. J., Califf, R. M.
(1998). Prognostic value of congestive heart failure history in patients undergoing percutaneous coronary interventions. J Am Coll Cardiol
32: 936-941
[Abstract][Full Text]
Oesterle, S. N.
(1998). Beyond stents: third-generation coronary devices. Ann. Thorac. Surg.
66: 1045-1049
[Abstract][Full Text]
Narins, C. R., Holmes, D. R. Jr, Topol, E. J.
(1998). A Call for Provisional Stenting : The Balloon Is Back!. Circulation
97: 1298-1305
[Full Text]
Lucas, A., Dai, E., Liu, L.-Y., Nation, P. N
(1998). Atherosclerosis in Marek's disease virus infected hypercholesterolemic roosters is reduced by HMGCoA reductase and ACE inhibitor therapy. Cardiovasc Res
38: 237-246
[Abstract][Full Text]
Williams, D. O., Fahrenbach, M. C.
(1998). Directional Coronary Atherectomy : But Wait, There's More. Circulation
97: 309-311
[Full Text]
Baim, D. S., Cutlip, D. E., Sharma, S. K., Ho, K. K. L., Fortuna, R., Schreiber, T. L., Feldman, R. L., Shani, J., Senerchia, C., Zhang, Y., Lansky, A. J., Popma, J. J., Kuntz, R. E.
(1998). Final Results of the Balloon vs Optimal Atherectomy Trial (BOAT). Circulation
97: 322-331
[Abstract][Full Text]
Simonton, C. A., Leon, M. B., Baim, D. S., Hinohara, T., Kent, K. M., Bersin, R. M., Wilson, B. H., Mintz, G. S., Fitzgerald, P. J., Yock, P. G., Popma, J. J., Ho, K. K. L., Cutlip, D. E., Senerchia, C., Kuntz, R. E.
(1998). `Optimal' Directional Coronary Atherectomy : Final Results of the Optimal Atherectomy Restenosis Study (OARS). Circulation
97: 332-339
[Abstract][Full Text]
Baker, W. F. JR
(1998). Thrombosis and Hemostasis in Cardiology: Review of Pathophysiology and Clinical Practice (Part I). CLIN APPL THROMB HEMOST
4: 51-75
[Abstract]
Neschis, D. G., Safford, S. D., Raghunath, P. N., Langer, D. J., David, M. L., Hanna, A. K., Tomaszewski, J. E., Kariko, K., Barnathan, E. S., Golden, M. A.
(1998). Thermal Preconditioning Before Rat Arterial Balloon Injury : Limitation of Injury and Sustained Reduction of Intimal Thickening. Arterioscler. Thromb. Vasc. Bio.
18: 120-126
[Abstract][Full Text]
Appelman, Y. E A, Piek, J. J, Redekop, W. K, de Feyter, P. J, Koolen, J. J, David, G. K, Strikwerda, S., Tijssen, J. G P, Serruys, P. W, Swijndregt, E v, van Gemert, M. J C, Lie, K. I
(1998). Clinical events following excimer laser angioplasty or balloon angioplasty for complex coronary lesions: subanalysis of a randomised trial. Heart
79: 34-38
[Abstract][Full Text]
Bauters, C., Lablanche, J.-M., Van Belle, E., Niculescu, R., Meurice, T., Mc Fadden, E. P., Bertrand, M. E.
(1997). Effects of Coronary Stenting on Restenosis and Occlusion After Angioplasty of the Culprit Vessel in Patients With Recent Myocardial Infarction. Circulation
96: 2854-2858
[Abstract][Full Text]
Dai, E., Stewart, M., Ritchie, B., Mesaeli, N., Raha, S., Kolodziejczyk, D., Hobman, M. L., Liu, L. Y., Etches, W., Nation, N., Michalak, M., Lucas, A.
(1997). Calreticulin, a Potential Vascular Regulatory Protein, Reduces Intimal Hyperplasia After Arterial Injury. Arterioscler. Thromb. Vasc. Bio.
17: 2359-2368
[Abstract][Full Text]
Hsu, N.-W., Chen, C.-I., Mar, G.-Y., Chan, W.-L., Chen, J.-W., Kong, C.-W., Wang, S.-P., Wang, S.-P.
(1997). New Stenosis on Proximal Coronary Segment After Directional Atherectomy: Two Case Reports. ANGIOLOGY
48: 911-918
[Abstract]
Mariani, M. A., Boonstra, P. W., Grandjean, J. G., Peels, J. O. J., Monnink, S. H. J., den Heijer, P., Crijns, H. J. G. M.
(1997). MINIMALLY INVASIVE CORONARY ARTERY BYPASS GRAFTING VERSUS CORONARY ANGIOPLASTY FOR ISOLATED TYPE C STENOSIS OF THE LEFT ANTERIOR DESCENDING ARTERY. J. Thorac. Cardiovasc. Surg.
114: 434-439
[Abstract][Full Text]
Reifart, N., Vandormael, M., Krajcar, M., Gohring, S., Preusler, W., Schwarz, F., Storger, H., Hofmann, M., Klopper, J., Muller, S., Haase, J.
(1997). Randomized Comparison of Angioplasty of Complex Coronary Lesions at a Single Center : Excimer Laser, Rotational Atherectomy, and Balloon Angioplasty Comparison (ERBAC) Study. Circulation
96: 91-98
[Abstract][Full Text]
Stone, G. W., Hodgson, J. M., St Goar, F. G., Frey, A., Mudra, H., Sheehan, H., Linnemeier, T. J.
(1997). Improved Procedural Results of Coronary Angioplasty With Intravascular Ultrasound–Guided Balloon Sizing : The CLOUT Pilot Trial. Circulation
95: 2044-2052
[Abstract][Full Text]
Bosmans, J. M., Kockx, M. M., Vrints, C. J., Bult, H., De Meyer, G. R. Y., Herman, A. G.
(1997). Fibrin(ogen) and von Willebrand Factor Deposition Are Associated With Intimal Thickening After Balloon Angioplasty of the Rabbit Carotid Artery. Arterioscler. Thromb. Vasc. Bio.
17: 634-645
[Abstract][Full Text]
Dagianti, A., Rosanio, S., Penco, M., Dagianti, A., Sciomer, S., Tocchi, M., Agati, L., Fedele, F.
(1997). Clinical and Prognostic Usefulness of Supine Bicycle Exercise Echocardiography in the Functional Evaluation of Patients Undergoing Elective Percutaneous Transluminal Coronary Angioplasty. Circulation
95: 1176-1184
[Abstract][Full Text]
Topol, E. J., Califf, R. M., Van de Werf, F., Simoons, M., Hampton, J., Lee, K. L., White, H., Simes, J., Armstrong, P. W.
(1997). Perspectives on Large-Scale Cardiovascular Clinical Trials for the New Millennium. Circulation
95: 1072-1082
[Full Text]
Crossman, D.
(1997). Science, medicine, and the future: The future of the management of ischaemic heart disease. BMJ
314: 356-356
[Abstract][Full Text]
Lablanche, J.-M., Grollier, G., Lusson, J.-R., Bassand, J.-P., Drobinski, G., Bertrand, B., Battaglia, S., Desveaux, B., Juilliere, Y., Juliard, J.-M., Metzger, J.-P., Coste, P., Quiret, J.-C., Dubois-Rande, J.-L., Crochet, P. D., Letac, B., Boschat, J., Virot, P., Finet, G., Le Breton, H., Livarek, B., Leclercq, F., Beard, T., Giraud, T., McFadden, E. P., Bertrand, M. E.
(1997). Effect of the Direct Nitric Oxide Donors Linsidomine and Molsidomine on Angiographic Restenosis After Coronary Balloon Angioplasty: The ACCORD Study. Circulation
95: 83-89
[Abstract][Full Text]
Abdelmeguid, A. E., Topol, E. J.
(1996). The Myth of the Myocardial `Infarctlet' During Percutaneous Coronary Revascularization Procedures. Circulation
94: 3369-3375
[Full Text]
Bittl, J. A.
(1996). Advances in Coronary Angioplasty. NEJM
335: 1290-1302
[Full Text]
Abdelmeguid, A. E., Topol, E. J., Whitlow, P. L., Sapp, S. K., Ellis, S. G.
(1996). Significance of Mild Transient Release of Creatine Kinase–MB Fraction After Percutaneous Coronary Interventions. Circulation
94: 1528-1536
[Abstract][Full Text]
Stevens, J. H., Burdon, T. A., Siegel, L. C., Peters, W. S., Pompili, M. F., Goar, F. G. St., Berry, G. J., Ribakove, G. H., Vierra, M. A., Mitchell, R. S., Toomasian, J. M., Reitz, B. A.
(1996). Port-Access Coronary Artery Bypass With Cardioplegic Arrest: Acute and Chronic Canine Studies. Ann. Thorac. Surg.
62: 435-440
[Abstract][Full Text]
Haude, M., Caspari, G., Baumgart, D., Brennecke, R., Meyer, J., Erbel, R.
(1996). Comparison of Myocardial Perfusion Reserve Before and After Coronary Balloon Predilatation and After Stent Implantation in Patients With Postangioplasty Restenosis. Circulation
94: 286-297
[Abstract][Full Text]
King, S. B. III
(1996). Angioplasty From Bench to Bedside to Bench. Circulation
93: 1621-1629
[Full Text]
Lehmann, K. G., Melkert, R., Serruys, P. W.
(1996). Contributions of Frequency Distribution Analysis to the Understanding of Coronary Restenosis : A Reappraisal of the Gaussian Curve. Circulation
93: 1123-1132
[Abstract][Full Text]
Williams, D. O.
(1996). Dressing Up the Palmaz-Schatz Stent. Circulation
93: 400-402
[Full Text]
Kay, G. L., Sun, G.-W., Aoki, A., Prejean, C. A. Jr
(1995). Influence of Ejection Fraction on Hospital Mortality, Morbidity, and Costs for CABG Patients. Ann. Thorac. Surg.
60: 1640-1651
[Abstract][Full Text]
Weintraub, W. S., Mauldin, P. D., Becker, E., Kosinski, A. S., King, S. B. III
(1995). A Comparison of the Costs of and Quality of Life After Coronary Angioplasty or Coronary Surgery for Multivessel Coronary Artery Disease : Results From the Emory Angioplasty Versus Surgery Trial (EAST). Circulation
92: 2831-2840
[Abstract][Full Text]
Topol, E. J., Nissen, S. E.
(1995). Our Preoccupation With Coronary Luminology : The Dissociation Between Clinical and Angiographic Findings in Ischemic Heart Disease. Circulation
92: 2333-2342
[Abstract][Full Text]
Lefkovits, J., Holmes, D. R., Califf, R. M., Safian, R. D., Pieper, K., Keeler, G., Topol, E. J., Investigators, f. t. C.-I.
(1995). Predictors and Sequelae of Distal Embolization During Saphenous Vein Graft Intervention From the CAVEAT-II Trial. Circulation
92: 734-740
[Abstract][Full Text]
Ellis, S. G., Miller, D. P., Brown, K. J., Omoigui, N., Howell, G. L., Kutner, M., Topol, E. J.
(1995). In-Hospital Cost of Percutaneous Coronary Revascularization : Critical Determinants and Implications. Circulation
92: 741-747
[Abstract][Full Text]
Nagayama, Y., Takahashi, M., Shigematsu, M., Nagai, S.
(1995). Coronary Artery Disease in Dermatomyositis: A Case Report. ANGIOLOGY
46: 743-746
[Abstract]
Wolfe, M. W., Roubin, G. S., Schweiger, M., Isner, J. M., Ferguson, J. J., Cannon, A. D., Cleman, M., Cabin, H., Leya, F., Bonan, R., Strony, J., Adelman, B., Bittl, J. A.
(1995). Length of Hospital Stay and Complications After Percutaneous Transluminal Coronary Angioplasty : Clinical and Procedural Predictors. Circulation
92: 311-319
[Abstract][Full Text]
Detre, K., Yeh, W., Kelsey, S., Williams, D., Desvigne-Nickens, P., Holmes, D. Jr, Bourassa, M., King, S. III, Faxon, D., Kent, K.
(1995). Has Improvement in PTCA Intervention Affected Long-term Prognosis? : The NHLBI PTCA Registry Experience. Circulation
91: 2868-2875
[Abstract][Full Text]
Abdelmeguid, A. E., Whitlow, P. L., Sapp, S. K., Ellis, S. G., Topol, E. J.
(1995). Long-term Outcome of Transient, Uncomplicated In-Laboratory Coronary Artery Closure. Circulation
91: 2733-2741
[Abstract][Full Text]
Brown, D. L., Hibbs, M. S., Kearney, M., Loushin, C., Isner, J. M.
(1995). Identification of 92-kD Gelatinase in Human Coronary Atherosclerotic Lesions : Association of Active Enzyme Synthesis With Unstable Angina. Circulation
91: 2125-2131
[Abstract][Full Text]
Elliott, J. M., Berdan, L. G., Holmes, D. R., Isner, J. M., King, S. B., Keeler, G. P., Kearney, M., Califf, R. M., Topol, E. J.
(1995). One-Year Follow-up in the Coronary Angioplasty Versus Excisional Atherectomy Trial (CAVEAT I). Circulation
91: 2158-2166
[Abstract][Full Text]
Keane, D., Haase, J., Slager, C. J., van Swijndregt, E. M., Lehmann, K. G., Ozaki, Y., di Mario, C., Kirkeeide, R., Serruys, P. W.
(1995). Comparative Validation of Quantitative Coronary Angiography Systems : Results and Implications From a Multicenter Study Using a Standardized Approach. Circulation
91: 2174-2183
[Abstract][Full Text]
Dralle, J. G., Turner, C., Hsu, J., Replogle, R. L.
(1995). Coronary Artery Aneurysms After Angioplasty and Atherectomy. Ann. Thorac. Surg.
59: 1030-1035
[Abstract][Full Text]
Holmes, D. R. Jr, Topol, E. J., Califf, R. M., Berdan, L. G., Leya, F., Berger, P. B., Whitlow, P. L., Safian, R. D., Adelman, A. G., Kellett, M. A. Jr, Talley, J. D. III, Shani, J., Gottlieb, R. S., Pinkerton, C. A., Lee, K. L., Keeler, G. P., Ellis, S. G.
(1995). A Multicenter, Randomized Trial of Coronary Angioplasty Versus Directional Atherectomy for Patients With Saphenous Vein Bypass Graft Lesions. Circulation
91: 1966-1974
[Abstract][Full Text]
Rodriguez, A. E., Santaera, O., Larribau, M., Fernandez, M., Sarmiento, R., Balino, N. P., Newell, J. B., Roubin, G. S., Palacios, I. F.
(1995). Coronary Stenting Decreases Restenosis in Lesions With Early Loss in Luminal Diameter 24 Hours After Successful PTCA. Circulation
91: 1397-1402
[Abstract][Full Text]
Bauters, C., Khanoyan, P., Mc Fadden, E. P., Quandalle, P., Lablanche, J.-M., Bertrand, M. E.
(1995). Restenosis After Delayed Coronary Angioplasty of the Culprit Vessel in Patients With a Recent Myocardial Infarction Treated by Thrombolysis. Circulation
91: 1410-1418
[Abstract][Full Text]
Kern, M. J., Bach, R. G., Kallfelz, M. L. d. A., Degrazia, R. C., Rashdan, I., Tolchin, D., Ania, B. J., Cardenes, M. A., Pauker, S. G., Kopelman, R. I.
(1995). Clinical Problem-Solving: Invasive Interventions. NEJM
332: 125-127
[Full Text]
Nunes, G. L., Sgoutas, D. S., Redden, R. A., Sigman, S. R., Gravanis, M. B., King, S. B. III, Berk, B. C.
(1995). Combination of Vitamins C and E Alters the Response to Coronary Balloon Injury in the Pig. Arterioscler. Thromb. Vasc. Bio.
15: 156-165
[Abstract][Full Text]
McMurray, J, Rankin, A
(1994). Recent Advances: Cardiology - I: Treatment of myocardial infarction, unstable angina, and angina pectoris. BMJ
309: 1343-1350
[Full Text]
Hamm, C. W., Reimers, J., Ischinger, T., Rupprecht, H.-J., Berger, J., Bleifeld, W., The German Angioplasty Bypass Surgery Investigatio,
(1994). A Randomized Study of Coronary Angioplasty Compared with Bypass Surgery in Patients with Symptomatic Multivessel Coronary Disease. NEJM
331: 1037-1043
[Abstract][Full Text]
King, S. B., Lembo, N. J., Weintraub, W. S., Kosinski, A. S., Barnhart, H. X., Kutner, M. H., Alazraki, N. P., Guyton, R. A., Zhao, X.-Q., The Emory Angioplasty versus Surgery Trial (EAST),
(1994). A Randomized Trial Comparing Coronary Angioplasty with Coronary Bypass Surgery. NEJM
331: 1044-1050
[Abstract][Full Text]
(C.A.S.); Jewish Hospital, Louisville, Ky. (R.R.M.); Erasmus University, Rotterdam, the Netherlands (P.W.S.); Washington Cardiology Center, Washington, D.
