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Cutting balloon angioplasty is superior to balloon angioplasty or stent implantation for small coronary artery disease

Iijima, Raisukea; Ikari, Yujia; Wada, Masamichib; Shiba, Masanorib; Nakamura, Masatob; Hara, Kazuhiroa

Therapy and Prevention
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The aim of this study is to demonstrate initial results and long-term outcomes of patients after receiving cutting balloon angioplasty (CBA), balloon angioplasty (BA), or stenting for small vessel diseases. We studied a total of 327 lesions of small coronary disease treated either by CBA (n=87), BA (n=130), or stenting (n=110) in two affiliated institutes. A small coronary artery was defined as a reference vessel <2.5 mm using quantitative coronary angiography (QCA). Angiographic restenosis was encountered in 31% of the CBA, 46.5% of the BA, and 43.9% of the stent (p=0.048). Major adverse cardiac events (death, myocardial infarction, and target lesion revascularization) at follow-up were significantly lower in the CBA compared to other groups (CBA, 20.3%; BA, 37.3%; stent, 33.3%; p=0.036). The CBA procedure provided superior angiographic and clinical outcomes to the stenting or BA. The CBA may be a cost-effective and reasonable approach for the treatment of lesions in small coronary diseases.

The aim of this study is to demonstrate initial results and long-term outcomes of patients after cutting balloon angioplasty (CBA), balloon angioplasty (BA), or stent implantation for small vessel diseases. We studied a total of 327 small coronary disease cases of less than 2.5 mm, treated either by CBA (87 lesions), BA (130 lesions), and stenting (110 lesions). Angiographic restenosis was encountered in 31% of the CBA cases, 46.5% of the BA, and 43.9% of the stent (p=0.048). The CBA revealed an event-free advantage at 9 months (p=0.036). The CBA procedure provided superior angiographic and clinical outcomes to the stenting and BA in small coronary diseases.

aDivision of Cardiology, Mitsui Memorial Hospital, Tokyo

bDivision of Cardiovascular Medicine, Toho University, Ohashi Hospital, Tokyo, Japan

Correspondence and requests for reprints to Raisuke Iijima, MD, Division of Cardiovascular Medicine, Toho university, Ohashi hospital, 2-17-6 Ohashi, Meguro-ku, 153-8515 Tokyo, Japan

Tel: +81 3 3468 1251; fax: +81 3 3468 1269;

e-mail: Raisuke329@aol.com

Received 25 February 2004 Revised 28 June 2004 Accepted 25 June 2004

© 2004 Lippincott Williams & Wilkins, Inc.