title: Medical treatment versus angioplasty for isolated ostial diagonal stenoses: a comparative clinical follow-up.
abstract: OBJECTIVE
  Angioplasty of a stenosis at the ostium of a diagonal branch of the left anterior descending artery as an isolated lesion often poses a dilemma due to the risk involved in treating the lesion in comparison to the potential benefit. Therefore, we sought to investigate our experience with this issue.
  
  
  METHODS
  Between 1995 and 2010, we retrospectively analyzed 39,300 patients who underwent invasive coronary angiography in our institution. Of these, a total of 22 had an isolated diagonal stenosis. The patients were either treated conservatively or underwent angioplasty and were followed for several years. Clinical and angiographic data were compared between the two groups.
  
  
  RESULTS
  Thirteen of the patients were treated conservatively and 9 underwent successful PCI. Baseline characteristics did not differ between the groups. The severity of the stenosis was also similar in the two groups, but in the angioplasty group, the diameter of the vessel was significantly larger (P<.01). More patients were recatheterized during the follow-up period in the conservative arm, although this did not reach statistical difference. There was no difference in mortality between the two groups.
  
  
  CONCLUSIONS
  Initial conservative medical approach is a reasonable approach in treating isolated diagonal ostial stenosis.
authors.affiliation: Cardiology Department, Soroka University Medical Center, Beer-Sheva, Israel. iliar@bgu.ac.il
authors.forename: Jean Marc
authors.initials: JM
authors.lastname: Weinstein
authors.forename: Carlos
authors.initials: C
authors.lastname: Cafri
authors.forename: Arik
authors.initials: A
authors.lastname: Wolak
authors.forename: Reuben
authors.initials: R
authors.lastname: Ilia
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents