Background - When it is impossible to cross and to dilate the lesion, particularly calcified lesions, ostial lesions, bifurcation lesions, long lesions (10-25mm) and when diffuse in-stent restenosis could be considered complex, rotary ablation may be a more effective treatment than Percutaneus Transluminal Coronary Angioplasty (PTCA) in this setting. This study evaluated the clinical safety, immediate and mid-term results of rotational atherectomy (RA) followed by balloon dilatation for the treatment of complex lesions of the coronary arteries. Methods - Between July 1998 and October 2000, 38 consecutive patients with complex lesions were treated with RA. Seventy six percent of the lesions were calcified, 21% were ostial, 16% of the lesions were un-crossable and 21% of the patients had diffuse in-stent restenosis. Fifty percent of the patients underwent angiography and all of them underwent exercise thallium scanning at six months’ follow-up. Results - Procedural success was achieved in 97% of the cases. Creatine kinase MB enzyme elevation occurred in 5.3%. Minimum luminal diameter (MLD) increased from 0.55± 0.25mm to 1.9±0.41mm after RA and to 2.65±0.35mm after adjunct PTCA. The mean burr to artery ratio was 0.69±0.16 and the mean balloon to artery ratio was 1.1±0.1 and balloon dilatation was performed at 12±2atm. There was neither Q-wave myocardial infarction nor death at a mean follow up of 11±3 months. Restenosis occurred in 21% of the patients with target vessel revascularization (TVR) of 16%. Conclusion: Coronary rotational atherectomy is a safe and feasible technique and is associated with a high success rate and a relatively low restenosis rate in the treatment of complex undilatable lesions.
MOMTAHEN, M., ABDI, S., NOUHI, F., PEYGHAMBARI, M., MOHSENI, M., SADR-AMELI, M., & MOMTAHEN, A. (2001). ROTATIONAL ATHERECTOMY FOR COMPLEX LESIONS:ACUTE AND MID-TERM RESULTS. Iranian Heart Journal, 2(2.3), 5-10.
MLA
M MOMTAHEN; S.A ABDI; F. NOUHI; M. PEYGHAMBARI; M. MOHSENI; M.A. SADR-AMELI; A.J. MOMTAHEN. "ROTATIONAL ATHERECTOMY FOR COMPLEX LESIONS:ACUTE AND MID-TERM RESULTS". Iranian Heart Journal, 2, 2.3, 2001, 5-10.
HARVARD
MOMTAHEN, M., ABDI, S., NOUHI, F., PEYGHAMBARI, M., MOHSENI, M., SADR-AMELI, M., MOMTAHEN, A. (2001). 'ROTATIONAL ATHERECTOMY FOR COMPLEX LESIONS:ACUTE AND MID-TERM RESULTS', Iranian Heart Journal, 2(2.3), pp. 5-10.
VANCOUVER
MOMTAHEN, M., ABDI, S., NOUHI, F., PEYGHAMBARI, M., MOHSENI, M., SADR-AMELI, M., MOMTAHEN, A. ROTATIONAL ATHERECTOMY FOR COMPLEX LESIONS:ACUTE AND MID-TERM RESULTS. Iranian Heart Journal, 2001; 2(2.3): 5-10.
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