Document Detail


High-speed rotational atherectomy and coronary stenting: QCA and QCU analysis.
MedLine Citation:
PMID:  14517919     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To evaluate the acute effect of pretreatment with high-speed rotational atherectomy (HSRA) on stent deployment (rotastenting), we studied 33 patients with rotastenting of 40 segments, 34 patients with 40 coronary segments treated with Palmaz-Schatz stenting alone, and 34 patients with 40 segments treated with HSRA. The HSRA- and stent-alone patient groups were selected retrospectively by matching the quantitative coronary angiography (QCA) reference diameter (D ref). QCA revealed similar baseline percent of stenosis (85.3% +/- 12.4%), minimal luminal diameter (MLD), and D ref. The percent area expansion was calculated as a ratio between the minimal intrastent area and the reference area measured by intracoronary ultrasound. The rotastent group was characterized by more frequent calcification compared to HSRA and stent groups (67.5% vs. 20% and 12.5%; P < 0.01). Lesion length determined by QCA was longer both in the HSRA and the rotastent groups vs. the stent-alone group (21.1 +/- 12.3 and 20.9 +/- 4.3 vs. 17.0 +/- 7.7 mm; P < 0.05). In this small study, there was no difference demonstrated between final MLD in the rotastent and stent-alone groups. However, a smaller MLD was achieved in the HSRA group (3.0 +/- 0.7 vs. 3.1 +/- 0.5 vs. 2.5 +/- 0.7 mm, respectively; P < 0.01). The degree of stent expansion was higher in the rotastent group compared to the stent-alone group (91.9% +/- 4.4% vs. 79.7% +/- 3.4%; P < 0.03) and the % residual area of plaque was less for the rotastent group than for the stent-alone group (12.1% +/- 13.2% vs. 21.1% +/- 17.5%; P = 0.03). These data suggest that antecedent HSRA atheroma debulking using HSRA results in improved intravascular stent expansion and reduction in residual plaque, facilitating optimal stent deployment.
Authors:
Robert J Whitbourn; Rajiv Sethi; Eugene V Pomerantsev; Peter J Fitzgerald
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  60     ISSN:  1522-1946     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-09-30     Completed Date:  2004-03-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  167-71     Citation Subset:  IM    
Copyright Information:
Copyright 2003 Wiley-Liss, Inc.
Affiliation:
Cardiology Department, St Vincent's Hospital Melbourne, Melbourne, Australia. whitbor@svhm.org.au
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MeSH Terms
Descriptor/Qualifier:
Aged
Atherectomy, Coronary*
Blood Vessel Prosthesis Implantation
Calcinosis / diagnosis,  surgery
Combined Modality Therapy
Coronary Angiography
Coronary Disease / diagnosis,  surgery*
Device Removal
Female
Humans
Male
Middle Aged
Stents*
Treatment Outcome
Ultrasonography, Interventional

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


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