The place of directional coronary atherectomy for the treatment of in-stent restenosis.
The beneficial short and long-term results of coronary stenting have resulted in a dramatic increase in stent utilization, accounting for greater than 80% of coronary interventions [1--9]. However, the long-term beneficial effect of coronary stenting is limited by the occurrence of a 14 to 61% restenosis rate [10--13]. The optimal percutaneous revascularization strategy for the treatment of in-stent restenosis remains undetermined. Although balloon angioplasty has been performed with high initial procedural success, the long-term results are disappointing due to significant recurrence [14--18]. In this article we describe the feasibility, safety, immediate and long-term outcome of directional coronary atherectomy (DCA) as a treatment modality in a cohort of patients undergoing percutaneous intervention for the treatment of in-stent restenosis at the Massachusetts General Hospital.
Cardiac Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. palacios.igor@mgh.harvard.edu
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Palacios
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PL
Sanchez
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Mahdi
D000368:Aged; D017225:Atherectomy, Coronary; D003324:Coronary Artery Disease / Q000601:surgery / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D015607:Stents; D016896:Treatment Outcome