INITIAL AND FOLLOW-UP RESULTS OF CORONARY ROTATIONAL ATHERECTOMY

Abstract

We assessed short-and long-term results of coronary rotational atherectomy (RA) in a consecutive series of 30 patients with 32 lesions. All lesions were complex and calcified (type B 2 or C). Minimal lumen diameter (MLD) was 2.71±0.46mm, and diameter stenosis 78±9%. Adjunctive low- or high-pressure balloon angioplasty or stenting after RA was conducted for all lesions, with procedural success obtained in 28 (87.5%). Final MLD was 2.17±0.69mm and diameter stenosis 20±14% after RA. Coronary artery dissection occurred in 7 lesions (25%) and delayed filling in 2 (7%). No patient had major complications, e.g., in-hospital death, Q-wave myocardial infarction, or emergency coronary artery bypass surgery. Angiographic follow-up was conducted for 17 lesions. MLD was 1.31±0.80mm and diameter stenosis 52±25%. Restenosis was seen in 8 lesions (47%), all of whom had success of target lesion revascularization. RA is thus useful in “debulking” and “lesion modification”, with a high success rate in complex lesions, and restenosis rates similar to balloon angioplasty.