Very long-term (15 to 23 years) outcomes of successful balloon angioplasty compared with bare metal coronary stenting.

Target lesion revascularization (tlr) continues to occur beyond 4 years after bare metal stent (bms) implantation. however,long-term outcomes after balloon angioplasty (ba) compared with bms are currently unknown. from 1989 to 1990,659 patients (748 lesions) underwent successful ba with final balloon ≥3.0 mm excluding patients with acute myocardial infarction and were compared with 405 patients (424 lesions) with bms implantation from june 1990 to 1993. cumulative incidences of death and target lesion thrombosis (>1 year) were similar between the ba group and the bms group (44.4% versus 45.4%,p=0.60; and 1.5% versus 0.7%,p=0.99; respectively). cumulative incidence of tlr during overall follow-up was significantly higher after ba than after bms implantation (44.6% versus 36.0%,p<0.001),whereas cumulative incidence of late tlr (>4 years) tended to be lower in the ba group than in the bms group (16.3% versus 21.4%,p=0.16). cumulative incidence of late tlr after ba was significantly lower in patients with small percent diameter stenosis (%ds) at early follow-up angiography compared with large %ds (14.5% versus 28.0%,p=0.02). in lesions with serial angiography,late lumen loss from early (6 to 14 months) to long-term (4 to 10 years) follow-up angiography was significantly smaller in the ba group (n=42) than in the bms group (n=55) (-0.08±0.45 mm versus 0.11±0.46 mm,p=0.047). compared with bms implantation,ba was associated with a trend for less late tlr beyond 4 years and with significantly smaller late lumen loss from early to long-term follow-up angiography.