Rotational atherectomy or balloon angioplasty in the treatment of intra-stent restenosis: BARASTER multicenter registry.
The BARASTER registry was formed to evaluate the initial success and long-term results of rotational atherectomy in the management of in-stent restenosis. Rotational atherectomy was used in 197 cases of in-stent restenosis: 46 with stand-alone rotational atherectomy or at most 1 atmosphere of balloon inflation (Rota strategy), and 151 with rotational atherectomy and adjunctive balloon angioplasty <1 atmosphere (Combination strategy). These were compared with 107 episodes of in-stent restenosis treated with balloon angioplasty alone. In this observational study, the use of Combination therapy was associated with a slightly higher initial success rate (95% vs. 87% with the Rota strategy and 89% with Balloons, P = 0.08). There was a reduction in one year clinical outcomes (death, myocardial infarction or target lesion revascularization) in the combination group (38% vs. 60% with Rota and 52% with balloons, P = 0.02). These data support a benefit of the strategy of debulking with rotational atherectomy followed by adjunctive balloon angioplasty, in the management of in-stent restenosis.
Goldberg
S L
SL
Harbor-UCLA Medical Center, Torrance, California, USA. Stevgold99@aol.com
Berger
P
P
Cohen
D J
DJ
Shawl
F
F
Buchbinder
M
M
Fortuna
R
R
O'Neill
W
W
Leon
M
M
Braden
G A
GA
Teirstein
P S
PS
Reisman
M
M
Bailey
S R
SR
Dauerman
H L
HL
Bowers
T
T
Mehran
R
R
Colombo
A
A
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017225:Atherectomy, Coronary; D003327:Coronary Disease / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D019233:Retreatment; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome