Initial Experience of Rotational Atherectomy in Coronary Artery Disease.
10.4070/kcj.1999.29.6.567
- Author:
Moo Hyun KIM
;
Kwang Soo CHA
;
Hye Jin KIM
;
Sang Gon KIM
;
Soo Hun LEE
;
Jeong Woon PARK
;
Young Dae KIM
;
Jeong Seong KIM
- Publication Type:Original Article
- Keywords:
Rotational atherectomy;
Complex lesion;
Stent restenosis
- MeSH:
Angina, Stable;
Angina, Unstable;
Angioplasty, Balloon;
Arteries;
Atherectomy;
Atherectomy, Coronary*;
Constriction, Pathologic;
Coronary Artery Disease*;
Coronary Vessels*;
Diagnosis;
Emergencies;
Hospital Mortality;
Humans;
Infarction;
Male;
Myocardial Infarction;
Stents
- From:Korean Circulation Journal
1999;29(6):567-574
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND:Rotational atherectomy has been developed for several years. It is a useful tool in complex coronary lesion morphologies such as diffuse, calcific, ostial and angulated lesion. We report initial experience of the rotational atherectomy in complex coronary artery morphology. METHODS: We included 64 patients who was treated with rotational atherectomy since July 1997 to February 1999. Mean age was 56+/-9 years with 47 male patients. Clinical diagnosis was 12 acute myocardial infarction, 49 unstable angina, and 3 stable angina. Rotational atherectomy was done by transfemoral or transradial approach with adjunctive ballooning and/or stenting in all patients. RESULTS: Ninty-one percent of the treated lesions showed complex lesion morphologies (B2/C lesion) with 43 left anterior descending artery and 19 right coronary artery. Rotational atherectomy was done in 37 de novo lesion (58%) and 27 (42%) restenosis patients. Transradial approach was done in 33 patients (52%). Mean maximal burr size was 1.68 mm and mean burr to reference artery ratio was 0.63. Rotastenting were done in 58% of the patients with higher post-procedure minimal lumen diameter, % diameter stenosis and net gain than rotablator with adjunctive balloon angioplasty. Overall procedural success was 94% (62/64). Complications were one non-Q infarction, one coronary artery perforation, two slow flow, and one guidewire fracture. None of the patients showed inhospital mortality or 30 day cardiac event (death, emergency CABG, Q-infarction, or re-intervention). CONCLUSION: Rotational atherectomy is a useful technique with high success rate without showing major cardiac events during inhospital period and within 30 days.
