title: Directional coronary atherectomy for the treatment of acute myocardial infarction.
abstract: Directional coronary atherectomy (DCA) was performed after intracoronary thrombolysis in 32 patients with a first acute myocardial infarction. DCA was successful in 31 (97%) of 32 patients. Abrupt closure of the treated segment occurred in one patient but was managed successfully by conventional balloon angioplasty. Repeat angiography was performed in 32 patients before discharge (2.7 +/- 0.7 weeks later) and in 29 patients during the follow-up (4.5 +/- 1.5 months later). No restenosis (stenosis > 50%) occurred before discharge; however restenosis occurred in 12 (41%) of 29 patients during follow-up. The restenosis rate in patients with subintimal resection was significantly higher than in those with intimal resection (78% vs 25%, p < 0.01). These data suggest that DCA in patients with acute myocardial infarction is feasible for persistent early patency of the infarct-related coronary artery, but late restenosis continues to limit success and subintimal resection may increase the restenosis rate during the follow-up.
authors.affiliation: Department of Cardiology, Hiroshima City Hospital, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kurisu
authors.forename: H
authors.initials: H
authors.lastname: Sato
authors.forename: H
authors.initials: H
authors.lastname: Tateishi
authors.forename: T
authors.initials: T
authors.lastname: Kawagoe
authors.forename: M
authors.initials: M
authors.lastname: Ishihara
authors.forename: Y
authors.initials: Y
authors.lastname: Shimatani
authors.forename: K
authors.initials: K
authors.lastname: Sakai
authors.forename: K
authors.initials: K
authors.lastname: Ueda
authors.forename: H
authors.initials: H
authors.lastname: Matsuura
mesh_terms: D000368:Aged; D017225:Atherectomy, Coronary; D003251:Constriction, Pathologic; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000473:pathology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D012008:Recurrence; D015912:Thrombolytic Therapy