Document Detail

Directional coronary atherectomy in 2005.
MedLine Citation:
PMID:  16008154     Owner:  NLM     Status:  MEDLINE    
The original aim of atherectomy was to reduce restenosis by means of aggressive plaque debulking, and the failure of large randomized trials to show any advantage of atherectomy over balloon angioplasty restricted its wider application. However, single-center registries in which aggressive debulking was performed by experienced operators have reported favorable results in terms of reduced restenosis and improved clinical outcomes when atherectomy was performed before stenting. Plaque debulking reduces the potential for plaque shift and facilitates subsequent high-pressure stent expansion, smoothes the internal vessel surface, scaffolds intimal flaps, and prevents elastic recoil. It has also been demonstrated that atherectomy can play a role in the treatment of complex lesions (ostial left anterior descending coronary artery lesions, left main lesions, and bifurcations), in which plaque shift may compromise the result of the procedure. New-generation devices have shown that atherectomy can be safely and effectively used to treat even relatively small vessels. In the current era of drug-eluting stents characterized by a considerable reduction in restenosis rates, optimal stent geometry and final luminal diameter are still important predictors of restenosis. Given the possible role of plaque shifting at the edges of a stent in causing restenosis, debulking could be added to the local drug effect in complex lesions.
Alessandra Repetto; Marco Ferlini; Maurizio Ferrario; Luigi Angoli; Ezio Bramucci
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Italian heart journal : official journal of the Italian Federation of Cardiology     Volume:  6     ISSN:  1129-471X     ISO Abbreviation:  Ital Heart J     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-07-12     Completed Date:  2005-10-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100909716     Medline TA:  Ital Heart J     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  494-7     Citation Subset:  IM    
Division of Cardiology, IRCCS Policlinico San Matteo, Pavia, Italy.
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MeSH Terms
Atherectomy, Coronary / trends*
Coronary Artery Disease / surgery*
Coronary Restenosis / prevention & control

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

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