[Predictive factors of coronary restenosis after optimal directional atherectomy. A multivariate analysis apropos of 102 patients].
The authors studied 102 patients prospectively who were undergoing coronary atherectomy optimised by balloon dilatation in order to assess the restenosis rate at 6 months. The coronary lesions were measured in a reproducible manner by quantitative angiography. The vessels dilated were the left anterior descending in 66 patients and the right coronary artery in 36 patients. The reference diameter was on average of 3.57 +/- 0.64 mm. Atherectomy increased the minimal diameter of the lesion of 1.20 +/- 0.44 to 3.01 +/- 0.44 mm giving a residual stenosis of 15 +/- 11%. At six months, 25% of patients had developed a restenosis (> 50% stenosis) with a residual lumen of 2.15 +/- 0.77 mm. The predictive factors of restenosis were the initial absolute gain, the length of the lesion, the reference diameter of the vessel and the presence of an endoluminal thrombus. In multivariate analysis, a small initial gain (p < 0.02) and length of stenosis (p < 0.02) were independently correlated with restenosis. The authors conclude: 1) that optimal atherectomy is associated with acceptable restenosis rates in selected vessels, 2) that short stenoses of large diameter arteries may be a privileged indication of the technique if the best results are obtained.
Coste
P
P
IFR Coeur-Vaisseaux-Thrombose, Inserm 4, CNRS FR 21, CHU de Bordeaux, Bordeaux Pessac.
Dos Santos
P
P
Sempé
S
S
Jaïs
C
C
Bonoron-Adèle
S
S
Duclos
F
F
Besse
P
P
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017225:Atherectomy, Coronary / Q000295:instrumentation / Q000379:methods; D015331:Cohort Studies; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012008:Recurrence; D015607:Stents; D016896:Treatment Outcome