A comparison of directional atherectomy with balloon angioplasty for lesions of the left anterior descending coronary artery

Article Abstract:

Directional coronary atherectomy may not be more effective than balloon angioplasty for the treatment of patients with narrowing of left anterior descending coronary artery. Atherectomy is a procedure that involves the direct removal of lipid-containing plaques from the inside of the coronary artery. Angioplasty is a procedure that uses a balloon catheter to flatten plaques against an artery wall. Among 265 patients with narrowing of the left descending coronary artery, 136 had atherectomy and 129 had angioplasty. The procedure was successful in 94% of the patients who had atherectomy, compared with 88% of those who had angioplasty. Five percent of the patients in the atherectomy group had in-hospital complications, compared to 6% of the patients in the angioplasty group. Of 257 patients who had follow-up angiography an average of six months after treatment, 133 had atherectomy and 124 had angioplasty. Re-narrowing of the coronary artery occurred in 46% of the patients who had atherectomy, compared to 43% of those who had angioplasty.

Coronary arteries, Arterial occlusive diseases

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A comparison of angioplasty with medical therapy in the treatment of single-vessel coronary artery disease

Article Abstract:

Percutaneous transluminal coronary angioplasty (PTCA) may be more effective than medication in reducing angina and increasing exercise tolerance in patients with single-vessel coronary artery disease. But it's an expensive procedure and not without complications. Of a group of patients with 70 to 99% stenosis (blockage) of a single coronary artery, 100 were treated with angioplasty and 107 were given nitroglycerin, a beta-blocker, a calcium-channel blocker or a combination. Both groups were followed for six months. During follow-up, patients in the PTCA group were encouraged to have another treatment if necessary. PTCA was initially successful in 80 patients and after six months, 16 had a repeat PTCA. After six months, 64% of the PTCA patients were free of angina compared to 46% of the medically-treated group. But five PTCA patients had a heart attack during follow-up and seven had to have bypass surgery. Three of the medically-treated patients had a heart attack and none had bypass surgery.

Drug therapy

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Coronary-artery stenting compared with balloon angioplasty for restenosis after initial balloon angioplasty

Article Abstract:

Coronary artery stenting may prevent the arteries from becoming blocked again after angioplasty. Stenting involves placing a small metal cylinder inside the artery to keep it open. Researchers randomly assigned 383 patients whose arteries had become blocked after receiving angioplasty to receive another angioplasty or a coronary artery stent. The stent was more effective than angioplasty in preventing further blockage but patients who received a stent were more likely to develop blood clots around the stent.

Atherosclerosis, Stent (Surgery), Stents

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