Document Detail


Acute and late clinical outcome after rotational atherectomy for complex coronary disease.
MedLine Citation:
PMID:  9786388     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Rotational atherectomy is effective acutely in treating complex coronary disease, but less is known about its long-term clinical outcome. We examined the acute results and late clinical outcome in 178 patients undergoing treatment with this device. Rotational atherectomy was used to treat 240 lesions in 178 individual patients. Nineteen percent had multilesion or staged multivessel procedures, and 71% had AHA-ACC Type B2/C lesions. The procedure was completed successfully in 94% of patients. Major complications occurred in 6% (death 1%, Q-MI 2.8%, and emergency bypass surgery 2.2%). Clinical follow-up was available for 167 (94%) patients at 13+/-6 months. Thirty-five percent required additional catheterization because of recurrent symptoms or an abnormal stress test. Clinical restenosis was confirmed in 18%, and an additional 2.2% of patients had progression of disease in previously untreated segments. At the end of 1 year, 14% had undergone repeat target vessel revascularization. Cumulatively at follow-up, approximately 80% had avoided an acute major complication and repeat revascularization for restenosis. Rotational atherectomy provides excellent acute and good late clinical results. At 1 year follow-up, the likelihood of developing clinical restenosis or significant progression of disease was 1 in 5, and patients had a 1 in 7 chance of requiring revascularization because of restenosis. These findings are encouraging and indicate that rotational atherectomy can be performed safely and with a high degree of acute and late clinical success in complex coronary disease characterized by multivessel or multilesion involvement and a predominance of B2 and C lesions.
Authors:
T N Levin; S Holloway; T Feldman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular diagnosis     Volume:  45     ISSN:  0098-6569     ISO Abbreviation:  Cathet Cardiovasc Diagn     Publication Date:  1998 Oct 
Date Detail:
Created Date:  1998-12-16     Completed Date:  1998-12-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7508512     Medline TA:  Cathet Cardiovasc Diagn     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  122-30     Citation Subset:  IM    
Affiliation:
University of Chicago Hospital, Hans Hecht Hemodynamics Laboratory, Pritzker School of Medicine, IL 60637, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Atherectomy, Coronary* / adverse effects,  economics
Coronary Disease / economics,  therapy*
Costs and Cost Analysis
Disease Progression
Exercise Test
Female
Heart Catheterization / economics
Humans
Male
Middle Aged
Recurrence
Retrospective Studies
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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