Abstract
Aim. The use of rotational atherectomy in addition to standard percutaneous coronary interventional procedures, although it improves coronary blood flow dynamics by improving vessel geometry, is often associated with distal embolization and the no-reflow phenomenon. We sought to evaluate the safety and effectiveness of a burr size/reference artery diameter (RAD) ratio <0.7 in rotational atherectomy in order to reduce the distal embolization and then to analyze the procedural and peri-procedural no-reflow phenomenon. Methods. Between March 1999 and May 2003, 50 consecutive patients with a chronic stable angina lasting more than 3 months underwent rotablator atherectomy, adjunctive stent implantation (primary coronary stenting, PCS) or plain old balloon angioplasty (POBA) in case of de novo lesions or in stent restenosis, respectively. We analyzed the target vessel myocardial blush grade and the troponin I, creatine kinase and CK-MB values at 1.6 and every 8 h during the first day and then daily until discharge. Results. Procedural success was achieved in all 50 patients (mean age 55±11 years; 45 males, 5 females). Quantitative angiography revealed, in the group treated with PCS, an increase in minimal lumen diameter (MLD) from 0.88±0.39 min at baseline to 1.4±0.63 mm after rotablator (p<0.01) to 2.85±0.9 ]mm after stent implantation (p<0.01). On the other hand, for the group treated with POBA, the MLD changed from 1.8±0.32 mm at baseline to 2.2±0.54 mm after rotablator (p=0.6) to 3.28±0.91 mm after adjunctive balloon angioplasty (p<0.01). No statistically significant changes have been observed between myocardial blush grade and enzymes between baseline and after the procedure. Conclusion. Rotablator atherectomy with a reduced burr size/RAD ratio is a safe and effective interventional procedure without any periprocedural no-reflow phenomenon.
| Original language | Italian |
|---|---|
| Pages (from-to) | 209-217 |
| Number of pages | 9 |
| Journal | Minerva Cardioangiologica |
| Volume | 52 |
| Issue number | 3 |
| Publication status | Published - Jun 2004 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
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Effetti sul no-reflow dell'aterectomia rotazionale con ridotto rapporto fresa-diametro vasale. / Sardella, G.; De Luca, L.; Adorisio, R.; Di Russo, C.; Fedele, F.
In: Minerva Cardioangiologica, Vol. 52, No. 3, 06.2004, p. 209-217.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Effetti sul no-reflow dell'aterectomia rotazionale con ridotto rapporto fresa-diametro vasale
AU - Sardella, G.
AU - De Luca, L.
AU - Adorisio, R.
AU - Di Russo, C.
AU - Fedele, F.
PY - 2004/6
Y1 - 2004/6
N2 - Aim. The use of rotational atherectomy in addition to standard percutaneous coronary interventional procedures, although it improves coronary blood flow dynamics by improving vessel geometry, is often associated with distal embolization and the no-reflow phenomenon. We sought to evaluate the safety and effectiveness of a burr size/reference artery diameter (RAD) ratio <0.7 in rotational atherectomy in order to reduce the distal embolization and then to analyze the procedural and peri-procedural no-reflow phenomenon. Methods. Between March 1999 and May 2003, 50 consecutive patients with a chronic stable angina lasting more than 3 months underwent rotablator atherectomy, adjunctive stent implantation (primary coronary stenting, PCS) or plain old balloon angioplasty (POBA) in case of de novo lesions or in stent restenosis, respectively. We analyzed the target vessel myocardial blush grade and the troponin I, creatine kinase and CK-MB values at 1.6 and every 8 h during the first day and then daily until discharge. Results. Procedural success was achieved in all 50 patients (mean age 55±11 years; 45 males, 5 females). Quantitative angiography revealed, in the group treated with PCS, an increase in minimal lumen diameter (MLD) from 0.88±0.39 min at baseline to 1.4±0.63 mm after rotablator (p<0.01) to 2.85±0.9 ]mm after stent implantation (p<0.01). On the other hand, for the group treated with POBA, the MLD changed from 1.8±0.32 mm at baseline to 2.2±0.54 mm after rotablator (p=0.6) to 3.28±0.91 mm after adjunctive balloon angioplasty (p<0.01). No statistically significant changes have been observed between myocardial blush grade and enzymes between baseline and after the procedure. Conclusion. Rotablator atherectomy with a reduced burr size/RAD ratio is a safe and effective interventional procedure without any periprocedural no-reflow phenomenon.
AB - Aim. The use of rotational atherectomy in addition to standard percutaneous coronary interventional procedures, although it improves coronary blood flow dynamics by improving vessel geometry, is often associated with distal embolization and the no-reflow phenomenon. We sought to evaluate the safety and effectiveness of a burr size/reference artery diameter (RAD) ratio <0.7 in rotational atherectomy in order to reduce the distal embolization and then to analyze the procedural and peri-procedural no-reflow phenomenon. Methods. Between March 1999 and May 2003, 50 consecutive patients with a chronic stable angina lasting more than 3 months underwent rotablator atherectomy, adjunctive stent implantation (primary coronary stenting, PCS) or plain old balloon angioplasty (POBA) in case of de novo lesions or in stent restenosis, respectively. We analyzed the target vessel myocardial blush grade and the troponin I, creatine kinase and CK-MB values at 1.6 and every 8 h during the first day and then daily until discharge. Results. Procedural success was achieved in all 50 patients (mean age 55±11 years; 45 males, 5 females). Quantitative angiography revealed, in the group treated with PCS, an increase in minimal lumen diameter (MLD) from 0.88±0.39 min at baseline to 1.4±0.63 mm after rotablator (p<0.01) to 2.85±0.9 ]mm after stent implantation (p<0.01). On the other hand, for the group treated with POBA, the MLD changed from 1.8±0.32 mm at baseline to 2.2±0.54 mm after rotablator (p=0.6) to 3.28±0.91 mm after adjunctive balloon angioplasty (p<0.01). No statistically significant changes have been observed between myocardial blush grade and enzymes between baseline and after the procedure. Conclusion. Rotablator atherectomy with a reduced burr size/RAD ratio is a safe and effective interventional procedure without any periprocedural no-reflow phenomenon.
KW - Atherectomy, coronary
KW - Coronary circulation
KW - Coronary disease
UR - http://www.scopus.com/inward/record.url?scp=3843149284&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=3843149284&partnerID=8YFLogxK
M3 - Articolo
VL - 52
SP - 209
EP - 217
JO - Minerva Cardioangiologica
JF - Minerva Cardioangiologica
SN - 0026-4725
IS - 3
ER -