New devices for percutaneous coronary intervention are rapidly making bypass surgery obsolete

Current Opinion in Cardiology

Volumn 19, Issue 6, 2004, Pages 593-597

  Baim, Donald S ^a  

^a BRIGHAM AND WOMEN S HOSPITAL   (United States)

Author keywords

Angioplasty; Drug eluting stents; Percutaneous coronary intervention

Indexed keywords

ACETYLSALICYLIC ACID; ANTICOAGULANT AGENT; ANTITHROMBOCYTIC AGENT; FIBRINOGEN RECEPTOR ANTAGONIST; HEPARIN; HIRULOG; LOW MOLECULAR WEIGHT HEPARIN; METAL;

ARTERY INTIMA PROLIFERATION; CORONARY ARTERY BYPASS SURGERY; CORONARY STENT; DRUG ELUTING STENT; EMERGENCY SURGERY; HEART MUSCLE REVASCULARIZATION; HUMAN; PERCUTANEOUS CORONARY INTERVENTION; PRIORITY JOURNAL; RECURRENT DISEASE; RESTENOSIS; REVIEW; SAFETY; SYMPTOM; TRANSLUMINAL CORONARY ANGIOPLASTY;

ANGIOPLASTY, TRANSLUMINAL, PERCUTANEOUS CORONARY; BALLOON OCCLUSION; CORONARY ARTERY BYPASS; CORONARY DISEASE; EQUIPMENT AND SUPPLIES; HUMANS;

EID: 8344246118     PISSN: 02684705     EISSN: None     Source Type: Journal    
DOI: 10.1097/01.hco.0000142065.37837.b4     Document Type: Review

References (25)

1. Anderson HV, Shaw RE, Brindis RG, et al.: A contemporary overview of percutaneous coronary interventions. The American College of Cardiology-National Cardiovascular Data Registry (ACC-NCDR). J Am Coll Cardiol 2002, 39:1096-1103.
2. Seshadri N, Whitlow PL, Acharya N, et al.: Emergency coronary artery bypass surgery in the contemporary percutaneous coronary intervention era. Circulation 2002, 106:2346-2350.
3. Kuntz RE, Baim DS: Defining coronary restenosis: newer clinical and angiographic paradigms. Circulation 1993, 88:1310-1323.
4. Williams DO: Intracoronary brachytherapy: past, present, and future. Circulation 2002, 105:2699-2700.
5. Moses JW, Leon MB, Popma JJ, et al.: Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery. N Engl J Med 2003, 349:1315-1323. Pivotal US trial that randomly assigned 1100 patients to either bare metal or the rapamycin (Cypher) DES, showing a roughly 70% reduction in angiographic and clinical restenosis with the latter.
6. Stone GW, Ellis SG, Coxd DA, et al.: A polymer-based paclitaxel-eluting stent in patients with coronary artery disease. N Engl J Med 2003, 350:221-231.
7. Stone GW, Ellis SG, Cox DA, et al.: One-year clinical results with the slow-release, polymer-based, paclitaxel-eluting TAXUS stent: the TAXUS-IV trial. Circulation 2004, 109:1942-1947. Pivotal US trial that randomly assigned 1326 patients to either bare metal or paclitaxel (Taxus) slow-release DES, also showing approximately 70% reduction in angiographic and clinical restenosis.
8. The Bypass Angioplasty Revascularization Investigation (BARI) Investigators: Comparison of coronary bypass surgery with angioplasty in patients with multivessel disease. N Engl J Med 1996, 335:217-225.
9. Rodriguez A, Bernardi V, Navia J, et al.: Argentine randomized study: coronary angioplasty with stenting versus coronary bypass surgery in patients with multiple-vessel disease (ERACI II): 30-day and one-year follow-up results. ERACI II Investigators. J Am Coll Cardiol 2001, 37:51-58.
10. SoS investigators: Coronary artery bypass surgery versus percutaneous coronary intervention with stent implantation in patients with multivessel coronary artery disease (the Stent or Surgery trial): a randomized controlled trial. Lancet 2002, 360:965-970.
11. Legrand VM, Serruys PW, Unger F, et al.: Three-year outcome after coronary stenting versus bypass surgery for the treatment of multivessel disease. Circulation 2004, 109:1114. At 1 and 3 years after treatment, 1205 patients with multivessel coronary artery disease randomly assigned to either bypass or bare metal stenting in the ARTS study showed equal rates of survival without stroke or MI (88.4 vs 87.2%) but a lower rate of repeat revascularization (3.8 vs 21% at 1 year, mostly consisting of repeat PCI.
12. Pompa JJ, Wang JC: Advances in percutaneous coronary intervention. Adv Intern Med 2001, 46:307-358.
13. Kuntz RE, Baim DS, Cohen DJ, et al.: A trial comparing rheolytic thrombectomy with intracoronary urokinase for coronary and vein graft thrombus (the Vein Graft AngioJet Study [VeGAS 2]). Am J Cardiol 2002, 89:326-330.
14. Baim DS, Wahr D, George B, et al.: Randomized trial of a distal embolic protection device during percutaneous intervention of saphenous vein aortocoronary bypass grafts. Circulation 2002, 105:1285-1290. This study randomly assigned 801 patients undergoing saphenous vein graft stenting to performance over a conventional guidewire or the PercuSurge GuardWire (a distal occlusion-aspiration embolic protection device), showing a 42% reduction in major adverse clinical events (from 17.8 to 9.0%) and the no-reflow phenomenon (8.3 to 3.3%) by the protection from downstream atherembolization.
15. Stone GW, Rogers C, Hermiller J, et al.: Randomized comparison of distal protection with a filter-based catheter and a balloon occlusion and aspiration system during percutaneous intervention of diseased saphenous vein aortocoronary bypass grafts. Circulation 2003, 108:548-553. This randomized 650-patient study demonstrated that the EPI FilterWire (a nonocclusive distal filter embolic filter) was equivalent or better than the PercuSurge distal occlusion device in 30-day major adverse clinical events following stenting of diseased saphenous vein grafts (9.9 vs 11.6%). That demonstration plus greater ease of use has made the distal filter the dominant form of embolic protection.
16. Suero JA, Marso SP, Jones PG, et al.: Procedural outcomes and long-term survival among patients undergoing percutaneous coronary intervention of a chronic total occlusion in native coronary arteries: a 20-year experience. J Am Coll Cardiol 2001, 38:409-414.
17. Olivari Z, Rubartelli P, Piscione F, et al.: Immediate results and one-year clinical outcome after percutaneous coronary interventions in chronic total occlusions: data from a multicenter, prospective, observational study (TOASTGISE). J Am Coll Cardiol 2003, 41:1672-1678. This registry collected data on PCI attempts in 390 chronic total occlusion lesions at 29 Italian centers, showing technical success in 77.2% and in-hospital major adverse clinical events in 5.1%. At 12 months, patients with a successful vs unsuccessful procedure had a lower incidence of death or MI (1.05 vs 7.23%), a reduced need for bypass surgery (2.45 vs 15.7%), and better freedom from angina (88.7 vs 75%).
18. Whitborn RJ, Cincotta M, Mossop P, Selmon M: Intraluminal blunt microdissection for angioplasty of chronic total occlusion. Cathet Cardiovasc Interv 2003, 58:194-198. Blunt microdissection using a 0.039-inch catheter with openable blunt jaws at its tip is able to cross roughly 70% of chronic total occlusions in which a 10-minute attempt with conventional guidewires was unsuccessful.
19. Baim DS, Braden G, Heuser R, et al.: Utility of the safe-cross guided radio frequency total occlusion crossing system in chronic coronary total occlusions: results of the GREAT Registry Study. Am J Cardiol 2004, 94:853-858. In a 116-patient registry, the SafeCross guidewire (which combines optical coherence reflectometry guidance and the ability to deliver radiofrequency energy to its tip) was able to cross roughly 70% of chronic total occlusions in which a 10-minute attempt with conventional guidewires was unsuccessful.
20. Boekstegers P, Raake P, al Ghobainy R, et al.: Stent-based approach for ventricle-to-coronary artery bypass. Circulation 2002, 106:1000-1006.
21. Stone GW, Teirstein PS, Rubenstein R, et al.: A prospective, multicenter, randomized trial of percutaneous transmyocardial laser revascularization in patients with nonrecanalizable chronic total occlusions. J Am Coll Cardiol 2002, 39:1581-1587.
22. Patterson C, Runge MS: Therapeutic myocardial angiogenesis via vascular endothelial growth factor gene therapy: moving on down the road. Circulation 2000, 102:940-942.
23. El-Shafei A, Kern MJ: New techniques for the evaluation of the vulnerable plaque. J Invasive Cardiol 2002, 14:129-137.
24. Moreno PR, Lodder RA, Purushothaman KR, et al.: Detection of lipid pool, thin fibrous cap, and inflammatory cells in human aortic atherosclerotic plaques by near-infrared spectroscopy. Circulation 2002, 105:923-927.
25. Tatoulis J, Buxton BF, Fuller JA: Patencies of 2127 arterial to coronary conduits over 15 years. Ann Thorac Surg 2004, 77:93-101. Postoperative angiograms on 2127 patients with arterial conduits showed patencies of 96.4% for the left internal thoracic artery, 88.3% for the right internal thoracic artery, and 89.3 for the free radial graft; analysis of 3714 saphenous vein grafts showed patency of 61% (95% at 5 years, 71% at 10 years, and 32% at 15 years).