Side-branch occlusion after rotational atherectomy of in-stent restenosis: incidence, predictors, and clinical significance.
We evaluated the incidence, predictors, and clinical significance of side-branch occlusion (SBO) after rotational atherectomy (RA) for treatment of in-stent restenosis (ISR) and compared it with those of native coronary artery (NC). RA was performed in 64 patients with 34 ISR (42 side branches) and 30 NC (40 side branches). SBO occurred 14% after RA in ISR group compared with 0% in NC group (P < 0.05), and 33% after adjunctive balloon inflation in ISR group compared with 2.5% in NC group (P < 0.01). Non-Q myocardial infarction developed in seven patients in ISR group and four patients in NC group (P = NS). The presence of significant side-branch (SB) ostial disease (OR = 4.7, P < 0.05) and ISR lesions (OR = 15.5, P < 0.05) were the only independent predictors of SBO by multivariate analysis. The incidence of SBO is higher after RA of ISR than RA of NC and may be associated with an increased risk of non-Q myocardial infarction.
Cho
G Y
GY
Department of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
Lee
C W
CW
Hong
M K
MK
Kim
J J
JJ
Park
S W
SW
Park
S J
SJ
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D017225:Atherectomy, Coronary / Q000009:adverse effects*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011475:Prosthesis Failure; D012008:Recurrence; D012189:Retrospective Studies; D015607:Stents