PTCA CABG 2PTCA & CABG 3 4 PTCA CABG 1 2 3PTCA & CABG 4 5 PTCA CABG follow-up Japanese Circulation Journal Vol. 64, Suppl. IV, 2000

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19981999 JR PTCACABG 1 2 PTCA 3 PTCA 4 OP-CABG MID-CAB PTCACABG 1 PTCA PTCA CABG 2 1 PTCA PTCA PTCA PTCA PTCA 2CABG CABG CABG CABG 3PTCA CABG Japanese Circulation Journal Vol. 64, Suppl. IV, 2000 1009

19981999 1PTCA CABG 2PTCA & CABG 3 4 PTCA CABG 1 2 3PTCA & CABG 4 5 PTCA CABG follow-up 6 7 1010 Japanese Circulation Journal Vol. 64, Suppl. IV, 2000

CABG PTCA PTCA/CABG 6.47.5/1 10 1997 PTCA 108,584 CABG 17,036 1997 CABG 14,542 1/1 ACC/AHA PTCA 1993 PTCA POBA POBA POBA CABGCABG PTCA PTCACABG 1 PTCA CABG 456 QOL PTCACABG 45678 PTCA CABG PTCA QOL PTCA PTCA 1.5 PTCA 10 PTCA CABG PTCACABG CABG PTCA PTCA CABG PTCALITA CABG LITA CABGPTCA 11 PTCA CABG PTCACABG PTCA CABG 1213 QOL 14DM CABG Japanese Circulation Journal Vol. 64, Suppl. IV, 2000 1011

19981999 PTCA 10 1315 10 PTCA CABG CABG PTCA 16 CABG PTCA 17 PTCACABG 10 18192021222324 2 456725 PTCA QOL 3 511141516172526 PTCA PTCA CABG CABG 4 CABG 2728 PTCA PTCA 1 2930 0.6 0.3731 1.5 1.7931 1.4 1012 Japanese Circulation Journal Vol. 64, Suppl. IV, 2000

0.4931 5.824 2560 POBA ; 0.2DCA 1.31.8 0.4931 IABP PCPS PTCA 11 29 3233 34 PTCA ( CABG 30 PTCA 200 153536 CABG1.9435 3.64.6 3.4202.222 0.82.6 2.6202.222 1.84.1 1.820 2 Japanese Circulation Journal Vol. 64, Suppl. IV, 2000 1013

19981999 QOL PTCA CABG PTCA - 1.-- 34 50 1 unprotected LMT37383940 41 jeopardized collaterals CABG PTCA 1 DCA IABPPCPS IVUS 5075 PTCA 75 PTCA PTCA DCATEC PTCA PTCA PTCA CABG CABG CABG PTCA PTCA 15 mm 424344 90 PTCA ( PTCA -123 1014 Japanese Circulation Journal Vol. 64, Suppl. IV, 2000

PTCA MID-CAB CABG PTCA PTCA CABG CABG PTCA CABG 3738394041 CABG fi TEC fl CABG PTCA PTCA PTCA MID- CAB OP-CABG LITA PTCA 20 50 30 Ca 4546 HMG CoA EPA Ca 1 POBA 30404748 4950 POBA 104849 5051 3.0 mm DCA 525354 2054 TEC 45553056 50 57 Japanese Circulation Journal Vol. 64, Suppl. IV, 2000 1015

19981999 POBA CABG 2 58 CABG CABG PTCA 30 PTCA 3 PTCA PTCA CABG PTCA PTCA CABG PTCA CABG 59 60 75 PTCA PTCA (PTCA CABG -123 PTCA ( 1 PTCA CABG PTCA PTCA, CABG CABG PTCA, CABG 1016 Japanese Circulation Journal Vol. 64, Suppl. IV, 2000

2 10 11 12 13 PTCA 14 3 CABGPTCA EBM 4 PTCA CABG QOL ( PTCA CABG 300,000 600695216,000 40060075,000120,000 150 PTCA CABG PTCA Japanese Circulation Journal Vol. 64, Suppl. IV, 2000 1017

19981999 CABG PTCA CABG 1993 ACC/AHA V EBM FAX V EBM 1 10 2 Committee of Science Yasui H, et al. Thoracic and cardiovascular surgery in Japan during 1997. Annual report by the Japanese Association for Thoracic Surgery. Jap J Thorac Cardiovasc Surg 1999 ; 47 : 237-51. 3 ACC/AHA TASK FORCE REPORT. Guidelines for Percutaneous Transluminal Coronary Angioplasty A Report of American College of Cardiology / American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Committee on Percutaneous Transluminal Coronary Angioplasty). J Am Coll Cardiol 1993 ; 22 : 2033-54. 4 Parisi AP, et al., on behalf of the Veterans Affairs ACME Investigators. A comparison of angioplasty with medical therapy in the treatment of single-vessel coronary artery disease. N Eng J Med 1992 ; 326 : 10-6. 5 Hueb WA, et al. The medicine, angioplasty or surgery study (MASS) : A prospective, randomized trial of medical therapy, balloon angioplasty or bypass surgery for single proximal left anterior descending artery stenoses. J Am Coll Cardiol 1995 ; 26 : 1600-5. 6 RITA-2 trial participants. Coronary angioplasty versus medical therapy for angina : the second Randamised Intervention Treatment of Angina (RITA-2) trial. Lancet 1997 ; 350 : 461-8. 7 Strauss WE, et al., and the Veterans Affairs Study of Angioplasty Compared to Medical Therapy Investigators. A comparison of quality of life scores in patients with angina pectoris after angioplasty compared with after medical therapy. Outcomes of a randomized clinical trial. Circulation 1995 ; 92 : 1710-9. 8 Hartigan PM, et al. Two- to three-year follow-up of patients with single-vessel coronary artery disease randomized to PTCA or medical therapy (results of a VA cooperative study). Veterans Affairs Cooperative Studies Program ACME Investigators. Angioplasty Compared to Medicine. Am J Cardiol 1998 ; 82 : 1445-50. 9 Folland ED, et al., for the Veterans Affairs ACME Investigators. Percutaneous transluminal coronary angioplasty versus medical therapy for stable angina pectoris. Outcomes for patients with double-vessel versus single vessel coronary artery disease in a Veterans Affairs cooperative randomized trial. J Am Coll Cardiol 1997 ; 29 : 1505-11. 10 Pitt B, et al. Aggressive lipid-lowering therapy compared with angioplasty in stable coronary artery disease. Atorvastatin versus Revascularization Treatment Investigators. N Engl J Med 1999 ; 341 : 70-6. 11 O Keefe JH. et al. Isolated left anterior descending coronary artery disease : percutaneous transluminal coronary angioplasty 1018 Japanese Circulation Journal Vol. 64, Suppl. IV, 2000

versus stenting versus left internal mammary artery bypass grafting. Circulation 1999 ; 100 : II114-8. 12 RITA trial participants. Coronary angioplasty versus coronary artery bypass surgery : the Randomised intervention treatment of angina (RITA) trial. Lancet 1993 ; 341 : 573-80. 13 Weintraub WS, et al. Outcome of coronary bypass surgery versus coronary angioplasty in diabetic patients with multivessel coronary artery disease. J Am Coll Cardiol 1998 ; 31 : 10-9 14 Wahrborg P. Quality of life after coronary angioplasty or bypass surgery. 1-year follow-up in the Coronary Angioplasty versus Bypass Revascularization investigation (CABRI) trial. Eur Heart J 1999 ; 20 : 653-8. 15 The Bypass Angioplasty Revascularization Investigation (BARI) Investigators. Comparison of coronary bypass surgery with angioplasty in patients with multivessel disease. N Eng J Med 1996 ; 335 : 217-25. 16 Jones RH, et al. Long-term survival benefits of coronary artery bypass grafting and percutaneous transluminal angioplasty in patients with coronary artery disease. J Thorac Cardiovasc Surg 1996 ; 111 : 1013-25. 17 Hannan EL, et al. A comparison of three-year survival after coronary artery bypass graft surgery and percutaneous transluminal coronary angioplasty. J Am Coll Cardiol 1999 ; 33 : 63-72. 18 Nishiyama S. et al. Long-term prognosis in 990 medically treated Japanese patients with coronary artery disease. Jpn Heart J 1993 ; 34 : 539-50. 19 Hara K, et al. Long-term outcome of percutaneous transluminal coronary angioplasty and coronary bypass surgery for multivessel coronary artery disease. Jpn Circ J 1996 ; 60 : 940-6. 20 1996 ; 97 : 210-4 21 1996 ; 97 : 215-9 22 1997 ; 6 : 37-43 23 Modern Physician 1997 ; 17 : 65-9. 24 PTCA 199856 219-25 25 Solomon AJ, Gersh BJ. Management of chronic stable angina : Medical therapy, percutaneous transluminal coronary angioplasty, and coronary artery bypass graft surgery. Lessons from the randomized trials. Ann Intern Med. 1998 ; 128 : 216-23. 26 Pocock SJ, et al. Meta-analysis of randomised trials comparing coronary angioplasty with bypass surgery. Lancet 1995 ; 346 : 1184-9. 27 Cameron A, et al. (from the CAAS registry). Coronary bypass surgery with internal-thoracic artery grafts - Effects on survival over a 15-year period. N Eng J Med 1996 ; 334 : 216-9. 28 10 1996 ; 97 : 202-9 29 Meyer BJ, et al. Interventional cardiology in Europe 1993. Working Group on Coronary Circulation of the European Society of Cardiology. Eur Heart J 1996 ; 17 : 1318-28. 30 Baim DS, et al. Evaluating new devices. Acute (in-hospital) results from the New Approaches to Coronary Intervention Registry. Circulation 1994 ; 89 : 471-81. 31 10 PTCA 4834 32 Coronary 1999 ; 16 : 241-9. 33 Rotablator PTCA 1997 ; 50 : 1077-82 34 10. 5.22 86 35 1998 36 Coronary 1999 ; 16 : 221-8. 37 Ellis SG, et al. Contemporary percutaneous treatment of unprotected left main coronary stenosis : initial results from a multicenter registry analysis 1994-1996. Circulation 1997 ; 96 : 3867-72. 38 LMT PTCA 1998 ; 46 : 995-9 39 Kosuga K, et al. Initial and long-term results of angioplasty in unprotected left main coronary artery. Am J Cardiol 1999 ; 83 : 32-7. 40 Wong P, et al. A prospective study of elective stenting in unprotected left main coronary disease. Catheter Cardiovasc Interv 1999 ; 46 : 153-9. 41 Mebio 1999 ; 14 : 58-62. 42 Tan KH, et al. Determinants of success of coronary angioplasty in patients with a chronic total occlusion : a multiple logistic regression model to improve selection of patients. Br Heart J 1993 ; 70 : 126-31. 43 Puma JA, et al. Percutaneous revascularization of chronic coronary occlusions : an overview. J Am Coll Cardiol 1995 ; 26 : 1-11. 44 Kinoshita I, et al. Coronary angioplasty of chronic total occlusions with bridging collateral vessels : immediate and follow-up outcome from a large single-center experience. J Am Coll Cardiol 1995 ; 26 : 409-15. 45 Tamai H. et al. Impact of tranilast on restenosis after coronary angioplasty : Tranilast Restenosis Following Angioplasty Trial (TREAT). Am Heart J 1999 ; 138 : 968-75. 46 Yokoi H, et al. Effectiveness of an antioxidant in preventing restenosis after percutaneous transluminal coronary angioplasty : the Probucol Angioplasty Restenosis Trial. J Am Coll Cardiol 1997 ; 30 : 855-62. 47 Holmes DR Jr, et al. Restenosis after percutaneous transluminal coronary angioplasty (PTCA) : a report from the PTCA Registry of the National Heart, Lung, and Blood Institute. Am J Cardiol 1984 ; 53 : 77C-81C. 48 Versaci F, et al. A comparison of coronary-artery stenting Japanese Circulation Journal Vol. 64, Suppl. IV, 2000 1019

19981999 with angioplasty for isolated stenosis of the proximal left anterior descending coronary artery. N Eng J Med 1997 ; 336 : 817-22. 49 Fischman D, et al. A randomized comparison of coronarystent-placement and balloon angioplasty in the treatment of coronery artrey disease. N Eng J Med 1994 ; 331 : 496-501. 50 Serruys PW, et al. A comparison of balloon-expandable-stent implantation with balloon angioplasty in patients with coronary artery disease. N Eng J Med 1994 ; 331 : 489-95. 51 1999 ; 7 : 21-6 52 Topol EJ, et al. A comparison of directional coronary atherectomy with angioplasty on patients with coronary artery disease. The CAVEAT Study Group. N Engl J Med 1993 ; 329 : 221-7. 53 Popma JJ, et al. Early and late quantitative angiographic outcome in the optimal atherectomy restenosis study (OARS). J Am Coll Cardiol 1996 ; 27 : 291A. 54 Baim DS, et al. Final results in the ballooon vs optimal atherectomy trial (BOAT) : 6 month angiography and 1 year clinical follow-up. Circulation 1996 ; 94 : I-436. 55 Suzuki T, et al. Effects of adjunctive balloon angioplasty after intravascular ultrasound-guided optimal directional coronary atherectomy ; the result of Adjunctive Balloon Angioplasty After Coronary Atherectomy study. J Am Coll Cardiol 1999 ; 34 : 1028-35. 56 Ishizaka N, et al. Angiographic follow-up of patients after transluminal coronary extraction atherectomy. Am Heart J 1994 ; 128 : 691-6. 57 Reisman M, et al. Comparison of early and recent results with rotational atherectomy. J Am Coll Cardiol 1997 ; 29 : 353-7. 58 1997 ; p183-93. 59 cost-effectiveness 1994 ; 42 : 222-7 60 CEA (cost effectiveness analysis) Modern Physician 1997 ; 17 : 87-94. PTCACABG PTCA PTCA CABG 1998 PTCACABG 20 PTCA 157CABG 124 1 LMT PTCA 1,760 2,113 2,779 NA CABG NA 4,989 4,357 3,894 MID-CAB 2,617 PTCA 1,995 1,963 3,379 NA CABG NA 4,404 4,248 4.385 POBA 171,000 172,000 290,000 340,000 80,000 406,000 642,000 1020 Japanese Circulation Journal Vol. 64, Suppl. IV, 2000

245,000 630,000 2 LMT PTCA 677 1,265 1,648 NA CABG NA 30 12 127 MID-CAB 380 PTCA 983 1,226 1,863 NA CABG NA 242 5 80 restudy CAG 3040 30 1090 3 PTCA 13.111.7 8.813.9 CABG39.926.7 1.46.2 4 PTCA 118186 23 1695 198253 167236 3448 17020 CABG 3276892281 23 5 12345 RITA trial, RITA1 trial, BARI trial, EAST trial PTCA CABG substudy CABG PTCA 1.5 PTCA CABG CABG/PTCA 1.21.05 PTCA BARI trial PTCA 6 PTCA CABG PTCA CABG PTCA Japanese Circulation Journal Vol. 64, Suppl. IV, 2000 1021

19981999 1 Sculpher et al. Health service costs of coronary angioplasty and coronary artery bypass surgery : Randomised intervention treatment of angina (RITA) trial. Lancet 1994 ; 344 : 927-30. 2 Weintraub WS, et al. A comparison of the costs of and quality of life after coronary angioplasty or coronary surgery for multivessel coronary artery disease. Results from the Emory Angioplasty Versus Surgery Trial (EAST). Circulation 1995 ; 92 : 2831-40. 3 Hlatky MA et al. Medical care costs and quality of life after randomization to coronary angioplasty or coronary bypass surgery. N Eng J Med 1997 ; 336 : 92-9. 4 Henderson RA et al. Long-term results of RITA-1 trial : clinical and cost comparisons of coronary angioplasty and coronary-artery bypas grafting. Lancet 1998 ; 352 : 1419-25. 5 Hlatky MA, et al. Clinical correlates of the initial and longterm cost of coronary bypass surgery and coronary angioplasty. Am Heart J 1999 ; 138 : 376-83. 1022 Japanese Circulation Journal Vol. 64, Suppl. IV, 2000