title: Clinical results of coronary excimer laser angioplasty: report from the European Coronary Excimer Laser Angioplasty Registry.
abstract: From January 1991 to January 1993 the clinical and angiographic data of 470 patients were included in the European Coronary Excimer Laser Angioplasty Registry. Symptoms were CCS class 3 in 23% and CCS class 4 in 14.7%; unstable angina was present in 14.7% and 6.6% of patients had acute myocardial infarction. Of 477 treated lesions, 60% were type B2, and 19% type C. The lesion was located in the LAD in 61%, in the LCX in 16%, in the RCA in 20%, in a protected left main stem in 1.3% and in a saphenous vein graft in 2.5%, respectively. Failure of laser angioplasty occurred in 56 (12%) interventions. By multivariate analysis failure was associated with the intention to treat long segmental lesions (risk ratio (RR) 3.6, confidence interval (CI) 2.9 to 4.4; P = 0.0005), segments with severe prestenotic tortuosity (RR 3.5, CI 2.4 to 4.6; P = 0.02) and total occlusions (RR 2.1; CI 1.4 to 2.8; P = 0.05). Complications included vasospasm (13.4%), dissection (14.7%), flow limiting dissection (4%), reclosure (7.8%), and perforation (1.9%). Myocardial infarction occurred in 2.1%, CABG was requested in 1.9%, and the mortality was 1.5%. Procedural success was achieved in 89%. Individual morphological criteria for a reduced procedural success were the presence of a thrombus (RR 6.4; CI 5.0 to 7.7; P = 0.007) and vessel calcification (RR 2.6; CI 1.9 to 3.2; P = 0.005). Procedural success was slightly lower in type C lesions (86%) than in type B2 (88%) type B1 (95%), and type A lesions (92%), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Medizinische Klinik III, University of Tübingen, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Baumbach
authors.forename: H
authors.initials: H
authors.lastname: Oswald
authors.forename: J
authors.initials: J
authors.lastname: Kvasnicka
authors.forename: E
authors.initials: E
authors.lastname: Fleck
authors.forename: H J
authors.initials: HJ
authors.lastname: Geschwind
authors.forename: C
authors.initials: C
authors.lastname: Ozbek
authors.forename: N
authors.initials: N
authors.lastname: Reifart
authors.forename: M E
authors.initials: ME
authors.lastname: Bertrand
authors.forename: K R
authors.initials: KR
authors.lastname: Karsch
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D017222:Angioplasty, Balloon, Laser-Assisted / Q000009:adverse effects / Q000706:statistics & numerical data*; D003327:Coronary Disease / Q000453:epidemiology / Q000601:surgery*; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D015999:Multivariate Analysis; D012042:Registries / Q000706:statistics & numerical data*; D017211:Treatment Failure; D016896:Treatment Outcome