[Directional coronary atherectomy: effect of vessel size on primary results and long-term results].
Of 325 consecutive patients undergoing DCA, 263 patients with 277 stenoses were successfully treated with DCA alone and had angiographic follow-up 3-6 months later. Depending upon the initial reference diameter (RD) patients were divided into two subgroups: group I (n = 159) with a RD > 3 mm and group II (n = 104) showing a RD < or = 3 mm. In contrast to other series DCA was predominantly performed with 7F atherectomy devices using balloon inflation pressures of approximately 5 atm. Angiographic data including the minimal luminal diameter (MLD), percentage of stenosis (%D) and reference diameter (RD) were assessed by quantitative computer-assisted analysis before (pre), after (post) DCA and at a 3-6 months angiographic follow-up (FU). The percentage of diameter stenosis pre/post/FU in group I was 59.9 +/- 12.6%/18.4 +/- 12.8%/29.8 +/- 17.6%, and in group II 55.6 +/- 10.8%/17.8 +/- 12.3%/33.7 +/- 16.1% with a net gain at FU of 1.0 +/- 0.89 mm for group I and 0.86 +/- 0.66 mm for group II. Based on an angiographic restenosis criterion of at least 50% diameter obstruction at FU and or recurrence of symptoms warranting interventional re-treatment of the target lesion, the incidence of restenosis in group I was 20.6% and in group II 28.0% (p: n.s.). There was no significant difference between the two groups concerning complications. Our data show that DCA leads to a satisfying long-term result.(ABSTRACT TRUNCATED AT 250 WORDS)
Muurling
S I
SI
Klinik für Kardiologie, I. Medizinischen Universitätsklinik, Christian-Albrechts-Universität, Kiel.
Lins
M
M
Nagel
E
E
Alexander
H
H
Herrmann
G
G
Simon
R
R
D000328:Adult; D000368:Aged; D017225:Atherectomy, Coronary / Q000295:instrumentation; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000145:classification / Q000000981:diagnostic imaging*; D012307:Risk Factors
Direktionale koronare Atherektomie: Einfluss der Gefässgrösse auf primäre Ergebnisse und Langzeitresultate.