RANDOMIZED COMPARISON OF ANGIOPLASTY OF COMPLEX CORONARY LESIONS AT ASINGLE-CENTER - EXCIMER-LASER, ROTATIONAL ATHERECTOMY, AND BALLOON ANGIOPLASTY COMPARISON (ERBAC) STUDY

Background The purpose of this study was to test whether coronary reva scularization with ablation of either excimer laser or rotational athe rectomy can improve the initial angiographic and clinical outcomes com pared with dilatation (balloon angioplasty) alone. Methods and Results Al a single center, a total of 685 patients with symptomatic coronary disease warranting elective percutaneous revascularization for a comp lex lesion were randomly assigned to balloon angioplasty (n=222), exci mer laser angioplasty (n=232), or rotational atherectomy (n=231). The primary end point was procedural success (diameter stenosis <50%, abse nce of death, Q-wave myocardial infarction; or coronary artery bypass surgery). The patients who underwent relational atherectomy had a high er rate of procedural success than those who underwent excimer laser a ngioplasty or conventional balloon angioplasty (89% versus 77% and 80% , P=.0019), but no difference was observed in major in-hospital compli cations (3.2% versus 4.3% versus 3.1%, P=.71). At the 6-month follow-u p, revascularization of the original target lesion was performed more frequently in the rotational atherectomy group (42.4%) and the excimer laser group (46.0%) than in the angioplasty group (31.9%, P=.013). Co nclusions Procedural success of rotational atherectomy is superior to laser angioplasty and balloon angioplasty; however, it does not result in better late outcomes. The role of plaque debulking before balloon dilatation in percutaneous coronary revascularization remains to be fu lly defined.