Key result
Directional atherectomy increases 1-year death and drives a ~102% higher MI rate vs balloon angioplasty.
Why the study?
Does directional atherectomy improve long-term outcomes compared to balloon angioplasty in patients undergoing percutaneous revascularization?
RCT (n=1,012)
randomized
Does directional atherectomy improve long-term outcomes compared to balloon angioplasty in patients undergoing percutaneous revascularization?
Absolute Event Rate: 2.2% vs 0.6%
p-value: p=0.035
Directional atherectomy is associated with a higher 1-year rate of death and myocardial infarction compared to balloon angioplasty, raising significant safety concerns.
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Caution against directional atherectomy over angioplasty; challenges routine use and extends evidence of harm beyond 6 months.
Elliott et al. (1995) conducted an RCT in Coronary artery disease requiring percutaneous revascularization (n=1,012). Directional atherectomy vs. Balloon angioplasty was evaluated on Death (p=0.035). Directional atherectomy resulted in significantly higher rates of death (2.2% vs 0.6%, P=0.035) and myocardial infarction (8.9% vs 4.4%, P=0.005) at 1 year compared to balloon angioplasty.
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