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Directional Coronary Atherectomy of In‐stent Restenosis: A Two‐Center Experience

Directional Coronary Atherectomy of In‐stent Restenosis: A Two‐Center Experience Background: Tissue proliferation is the major cause of in‐stent restenosis (ISR). Thus, debulking of material should be the most favorable method to treat ISR. The present study was performed to test the clinical and angiographic outcome of directional coronary atherectomy (DCA) in the treatment of restenosis within different stents. Methods and Results: Fifty patients with ISR in single stents (12 Palrnaz‐Schatz stents, 8 Pura stents, 10 Multilink stents, 10 NIR stents, 8 Wallstents, and 2 Microstents) underwent DCA with adjunctive balloon angioplasty in 38 patients. Primary success was achieved in 48 patients (96%). Two patients developed CK‐MB elevations, one with a Q‐wave infarction. Some minor technical problems occurred with respect to the different stent types. The percent diameter stenosis decreased from 76 ± 7% at baseline to 29 ± 6% after atherectomy (P < 0.0001) and 20 ± 4% after adjunctive PTCA, and it increased to 45 ± 19% at 4‐month angiography (P < 0.0001). Angiographic restenosis occurred in 14 (29.2%) of 48 patients who were reevaluated after 4 months. Conclusion: While DCA is able to remove u significant amount of intimal tissue in selected patients with in‐stent restenosis, new atherectomy catheter designs are required to make this a feasible and safe procedure. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Interventional Cardiology Wiley

Directional Coronary Atherectomy of In‐stent Restenosis: A Two‐Center Experience

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References (22)

Publisher
Wiley
Copyright
Copyright © 2000 Wiley Subscription Services, Inc., A Wiley Company
ISSN
0896-4327
eISSN
1540-8183
DOI
10.1111/j.1540-8183.2000.tb00271.x
Publisher site
See Article on Publisher Site

Abstract

Background: Tissue proliferation is the major cause of in‐stent restenosis (ISR). Thus, debulking of material should be the most favorable method to treat ISR. The present study was performed to test the clinical and angiographic outcome of directional coronary atherectomy (DCA) in the treatment of restenosis within different stents. Methods and Results: Fifty patients with ISR in single stents (12 Palrnaz‐Schatz stents, 8 Pura stents, 10 Multilink stents, 10 NIR stents, 8 Wallstents, and 2 Microstents) underwent DCA with adjunctive balloon angioplasty in 38 patients. Primary success was achieved in 48 patients (96%). Two patients developed CK‐MB elevations, one with a Q‐wave infarction. Some minor technical problems occurred with respect to the different stent types. The percent diameter stenosis decreased from 76 ± 7% at baseline to 29 ± 6% after atherectomy (P < 0.0001) and 20 ± 4% after adjunctive PTCA, and it increased to 45 ± 19% at 4‐month angiography (P < 0.0001). Angiographic restenosis occurred in 14 (29.2%) of 48 patients who were reevaluated after 4 months. Conclusion: While DCA is able to remove u significant amount of intimal tissue in selected patients with in‐stent restenosis, new atherectomy catheter designs are required to make this a feasible and safe procedure.

Journal

Journal of Interventional CardiologyWiley

Published: Apr 1, 2000

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