782-2 Longterm Outcome of Excimer Laser Angioplasty Versus Balloon Angioplasty in Functional and Total Coronary Occlusions

From September 1991 until November 1993 we randomized 103 patients with functional and total coronary occlusions to Excimer Laser Coronary Angioplasty (ELCA, n=49) or Balloon Angioplasty (BA, n=54) as part of a multi-center trial (AMRO) comparing ELCA versus BA in type B or C-Iesions. We report on the longterm clinical and angiographic outcome of this subgroup. Procedural success (PS) was defined as <50% residual stenosis at the end of the procedure. Clinical endpoints were: death (D), myocardial infarction (MI), coronary bypass surgery (CABG) or repeat angioplasty (re-PTCA) of the randomized segment within 6 months follow-up. Angiographic endpoint was the net gain (NG) in minimal lumen diameter at six months follow-up relative to the pre-procedural baseline determined by a computer-assisted automated edge detection algorithm (CAAS II). Functional status (FS) at six months was graded according to the Canadian Cardiovascular Society classification. Results Baseline patient characteristics were similar in both groups. ELCA was followed by BA in all patients. Re-occlusion of the treated segment during 6 months follow-up was 33% in the ELCA group versus 23% in the BA group (not significant). n PS(%) D/MI/CAB/re-PTCA NG±SD FS(0-IV) ELCA 49 65 0/1/4/10 0.7±0.7 29/6/10/4/0 BA 54 61 0/3/2/8 0.7±0.7 27/5/12/8/2 None of the comparisons were significantly different. Conclusion Excimer Laser Angioplasty compared to Balloon Angioplasty in functional and total coronary occlusion yields similar results with respect to longterm clinical and angiographic outcome.