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Clinical and Angiographic Outcome after Cutting Balloon Angioplasty

Clinical and Angiographic Outcome after Cutting Balloon Angioplasty The cutting balloon is a new device for coronary angioplasty, that, by the combination of incision and dilatation of the plaque, is believed to be promising for treatment of in‐stent restenosis. The purpose of the study was to evaluate the safety and efficacy of CBA. We reviewed the immediate and 6‐month follow‐up angiographic and clinical outcome of 147 patients (109 men and 38 women) with a mean age of 67.3 ± 10 undergoing this procedure at eight interventional centers in Austria. The target lesions treated with CBA were in‐stent restenosis in 61% of patients, stenosis after balloon angioplasty in 8% of patients, and native lesions in 33% of patients. Sixty‐five percent of the patients included had multivessel disease. Lesion type was A in 18% of patients, B1 in 31% of patients, B2 in 39% of patients, and C in 12% of patients. The degree of stenosis was 87%± 9%, the length of the target lesion treated with CBA was 8.8 ± 5.1 mm . Target vessel was left circumflex artery in 22 cases, right coronary artery in 36 cases, and left anterior descending artery in 89 cases. The overall procedural success rate was 90.5%. “Stand‐alone” CBA was performed in 63% of patients, the procedure was combined with coronary stenting in 16% of patients, and with balloon angioplasty in 21% of patients. Coronary complications occurred in eight cases (5.4%) with coronary dissection in seven (total dissection rate of 4.7%) and urgent bypass surgery in one case (0.7%). No further complications such as death, occlusion, or perforation of coronary arteries, embolization, or thrombosis were observed. Six‐month clinical follow‐up revealed q‐wave myocardial infarction in 2.7% of patients, aortocoronary bypass surgery in 8.5% of patients, and repeated percutaneous coronary intervention in 17% of patients (11.5% with stenting). Six‐month angiographic follow‐up of patients with recurrent angina showed target lesion restenosis (>50% diameter stenosis) in 14% of patients, late lumen loss with ≤50% diameter stenosis in 6% of patients and progression of “other than target” lesions with >50% diameter stenosis in 14% of patients. This series demonstrates the safety and feasibility of cutting balloon angioplasty in patients with complex coronary artery disease and in‐stent restenosis. (J Interven Cardiol 2003;16:15–21) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Interventional Cardiology Wiley

Clinical and Angiographic Outcome after Cutting Balloon Angioplasty

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References (36)

Publisher
Wiley
Copyright
Copyright © 2003 Wiley Subscription Services, Inc., A Wiley Company
ISSN
0896-4327
eISSN
1540-8183
DOI
10.1046/j.1540-8183.2003.08010.x
Publisher site
See Article on Publisher Site

Abstract

The cutting balloon is a new device for coronary angioplasty, that, by the combination of incision and dilatation of the plaque, is believed to be promising for treatment of in‐stent restenosis. The purpose of the study was to evaluate the safety and efficacy of CBA. We reviewed the immediate and 6‐month follow‐up angiographic and clinical outcome of 147 patients (109 men and 38 women) with a mean age of 67.3 ± 10 undergoing this procedure at eight interventional centers in Austria. The target lesions treated with CBA were in‐stent restenosis in 61% of patients, stenosis after balloon angioplasty in 8% of patients, and native lesions in 33% of patients. Sixty‐five percent of the patients included had multivessel disease. Lesion type was A in 18% of patients, B1 in 31% of patients, B2 in 39% of patients, and C in 12% of patients. The degree of stenosis was 87%± 9%, the length of the target lesion treated with CBA was 8.8 ± 5.1 mm . Target vessel was left circumflex artery in 22 cases, right coronary artery in 36 cases, and left anterior descending artery in 89 cases. The overall procedural success rate was 90.5%. “Stand‐alone” CBA was performed in 63% of patients, the procedure was combined with coronary stenting in 16% of patients, and with balloon angioplasty in 21% of patients. Coronary complications occurred in eight cases (5.4%) with coronary dissection in seven (total dissection rate of 4.7%) and urgent bypass surgery in one case (0.7%). No further complications such as death, occlusion, or perforation of coronary arteries, embolization, or thrombosis were observed. Six‐month clinical follow‐up revealed q‐wave myocardial infarction in 2.7% of patients, aortocoronary bypass surgery in 8.5% of patients, and repeated percutaneous coronary intervention in 17% of patients (11.5% with stenting). Six‐month angiographic follow‐up of patients with recurrent angina showed target lesion restenosis (>50% diameter stenosis) in 14% of patients, late lumen loss with ≤50% diameter stenosis in 6% of patients and progression of “other than target” lesions with >50% diameter stenosis in 14% of patients. This series demonstrates the safety and feasibility of cutting balloon angioplasty in patients with complex coronary artery disease and in‐stent restenosis. (J Interven Cardiol 2003;16:15–21)

Journal

Journal of Interventional Cardiology – Wiley

Published: Feb 1, 2003

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