Effective plaque removal with a new 8 French-compatible atherectomy catheter.
The purpose of this study was to evaluate the safety and efficacy of the new 8 Fr guide catheter-compatible Flexicut directional atherectomy device and to compare it with the conventional Atherocath GTO catheter. The 6 Fr Flexicut catheter has a larger cutting window and a titanium nitride-coated cutter to effect more tissue removal as well as treat mildly calcified lesions. A group of 143 lesions in 117 consecutive patients treated with the Flexicut catheter in four centers were compared with a control group of 277 lesions in 212 consecutive patients treated with the GTO device. Postatherectomy luminal diameters were larger (2.92 +/- 0.79 vs. 2.52 +/- 0.64 mm; P < 0.0001), with more luminal gain (relative gain: 0.58 +/- 0.24 vs. 0.48 +/- 0.25; P = 0.0007) using fewer directional coronary atherectomy (DCA) cuts (12 +/- 7 vs. 16 +/- 9; P = 0.0001) in the Flexicut group. A residual diameter stenosis < 20% immediately after DCA was obtained in 77% of the lesions in the Flexicut group vs. 45% in the GTO group (P < 0.0001). Histology in the former group revealed large calcium speckles in the retrieved specimens. In the Flexicut group, there was a lower incidence of access site complications and damage to the coronary ostium (2.5% vs. 7.5%; P = 0.08). The new Flexicut catheter is more effective than the conventional GTO catheter with a trend for reduced guiding catheter-related complications.
Interventional Cardiology, San Raffaele Hospital and EMO Centro Cuore Columbus, Milan, Italy.
Takuro
T
Takagi
Carlo
C
Di Mario
Goran
G
Stankovic
Bernhard
B
Reimers
Alessandro
A
Alberti
Francesco
F
Liistro
Oksana
O
Kovalenko
Fabio
F
Sgura
Remo
R
Albiero
Flavio
F
Ribichini
Alessandro
A
Pugno
Antonio
A
Colombo
D017225:Atherectomy, Coronary / Q000295:instrumentation*; D016022:Case-Control Studies; D002404:Catheterization; D003324:Coronary Artery Disease / Q000473:pathology / Q000601:surgery; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies