Directional coronary atherectomy versus balloon angioplasty

Article Abstract:

Two research studies compared directional coronary atherectomy to balloon angioplasty for the treatment of patients with coronary artery disease. Directional atherectomy involves the direct removal of atherosclerotic plaques from the inside of a blood vessel. Balloon angioplasty is the widening of a blood vessel by means of a balloon catheter. Re-narrowing of the blood vessels often occurs in patients who have had balloon angioplasty. This procedure widens the diameter of blood vessels, but the atherosclerotic plaques are not removed. Both research studies found that directional atherectomy was more effective than balloon angioplasty for widening the artery. Patients who had atherectomy often had had a better short-term outcome. Their long-term outcome, however, was similar to or worse than that of patients who had balloon angioplasty and complications were more likely. The use of both of these procedures needs to be evaluated more carefully.

Editorial, Usage, Coronary heart disease, Arterial occlusive diseases

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Treatment with bivalirudin (Hirulog) as compared with heparin during coronary angioplasty for unstable or postinfarction angina

Article Abstract:

Bivalirudin may be as effective as heparin in preventing blood vessel blockage following coronary angioplasty, and may be less likely to cause bleeding. During angioplasty for chest pain or heart attack, 2,059 patients received bivalirudin and 2,039 received heparin. These anticlotting drugs were administered for approximately 24 hours, beginning just before the procedure. During six months of follow-up, the incidence of each of the following was approximately equal for both groups: death, heart attack, bypass surgery, and other complications of vessel blockage. However, among patients who had had chest pain following a heart attack before angioplasty, bivalirudin was more effective than heparin in preventing the above complications. Patients who received bivalirudin rather than heparin were less likely to experience a hemorrhage or need a blood transfusion.

Evaluation, Product/Service Evaluation, Complications and side effects, Heparin, Angioplasty, Hirulog (Medication)

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Advances in coronary angioplasty

Article Abstract:

Coronary angioplasty is a technique to open blocked coronary arteries. It uses a balloon, a surgical blade or a laser to remove plaque. A metal device called a stent can also be placed inside the artery to keep it open. However, many patients experience a recurrence of the blockage. Drugs used in conjunction with coronary angioplasty include aspirin, heparin and a monoclonal antibody called abciximab. Several studies have compared angioplasty to drug therapy and bypass surgery. However, physicians must also treat the systemic causes of atherosclerosis.

Health aspects, Equipment and supplies, Surgery, Anticoagulants (Medicine), Anticoagulants, Atherosclerosis

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