AUTOPERFUSION BALLOON VERSUS STENT FOR ACUTE OR THREATENED CLOSURE DURING PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY

Efficacy and major clinical end points were compared in 61 patients tr eated with a Stack autoperfusion balloon versus 36 patients who receiv ed a Palmaz-Schatz stent for acute or threatened closure during corona ry angioplasty. The groups were comparable regarding baseline clinical characteristics. Procedural success was achieved in 43 patients (70%) treated with an autoperfusion balloon versus 34 patients (94%) who re ceived a stent (p <0.02). Emergency bypass surgery was performed in 13 patients (21%) with the autoperfusion balloon versus none of the pati ents with a stent (p <0.001). in the stent group; 3 patients (8%) died (p <0.05); 2 deaths were caused by thrombotic reclosure, and 1 patien t died after unsuccessful stent delivery. Subacute reclosure during ho spitalization occurred in none of the patients with autoperfusion vers us 8 patients with the stent (22%) (p <0.0002). Therefore, the number of patients with successful stent implantation at discharge decreased to 26 (72%). At 3-month follow-up in all patients;with a successful in tervention, reclosure or angiographic restenosis (>50%) occurred in 13 patients with autoperfusion (30%) versus 3 patients with stents (12%) (p = NS). There was no difference in event-free survival during follo w-up. Thus, both interventions were equally successful in the treatmen t of acute and threatened closure. More emergency surgery was performe d in the autoperfusion balloon group, whereas a higher subacute reclos ure rate was seen in the stent group. At 3-month follow-up, there were no significant differences regarding reclosure, restenosis, and event -free survival.