Excimer laser coronary angioplasty of aorto-ostial stenoses Results of the excimer laser coronary angioplasty (ELCA) registry in the first 200 patients

Abstract

Background. Percutaneous transluminal coronary angioplasty (PTCA) of aorto-ostial stenosis has been associated with a lower rate of acute success, a high risk of vessel closure, and late restenosis. The purpose of this report is to document a prospective multicenter trial of excimer laser coronary angioplasty (ELCA) of aorto-ostial stenosis involving the coronary arteries and saphenous vein grafts. Methods and Results. Between December 1989 and May 1992, 206 aorto-ostial ELCA procedures were performed on 209 stenoses in 200 patients. Canadian Cardiovascular Society class III or IV angina was present in 76%. The distribution of stenosis locations was left main coronary (LM) in 26 (12%), right coronary (RCA) in 124 (59%), and vein grafts (VG) in 59 (28%). Adjunctive PTCA was performed in 72%. Procedure success defined as ≤50% diameter stenosis without major complications was achieved in 90% (LM, 92%; RCA, 89%; VG, 90%). Quantitative angiographic analysis documented an improvement in stenosis diameter from 0.8±0.5 mm or 76±14% at baseline to 2.1±0.6 mm or 36±15% at completion (P 50% diameter stenosis) occurred in 39% (LM, 64%; RCA, 35%; VG, 35%). Restenosis was less likely when residual stenosis was ≤35% (28% versus 53%, P