title: Efficacy of stenting after rotational atherectomy for ostial LAD and ostial LCX stenosis in patients with diabetes.
abstract: OBJECTIVE
  The goal of this study was to investigate the efficacy of stenting after rotational atherectomy (rotastent) for ostial LAD and ostial LCX stenosis in patients with diabetes.
  
  
  BACKGROUND
  Previous studies have demonstrated that rotastent for non-aorto ostial stenoses can be performed safely with high clinical success rate. However, in diabetic patients, long-term results of rotastent for ostial stenoses are still unknown.
  
  
  METHODS
  A series of 70 patients with de novo non-aorto ostial stenosis who underwent successful elective stenting after rotational atherectomy were the subject of this study. Clinical, angiographic, and procedural characteristics, as well as acute and chronic results were obtained for all patients.
  
  
  RESULTS
  There were no significant differences between diabetic versus non-diabetic patients in terms of baseline clinical characteristics, lesion characteristics, and procedural factors. The restenosis rate of diabetic patients was significantly higher than that of non-diabetic patients as assessed by the follow-up angiogram (53% versus 28%, respectively; p < 0.05). The rate of lesion progression which meant the development of new left main or non-treated artery-ostial narrowing was significantly higher in diabetic patients at follow-up angiography (23% versus 5%; p < 0.05 compared to non-diabetic patients). By use of multiple regression analysis, diabetes mellitus was identified as an independent predictor of restenosis and lesion progression.
  
  
  CONCLUSIONS
  These results suggest that diabetic patients are more likely to have not only higher rates of restenosis but also development of new left main narrowing or non-treated artery ostial narrowing compared to non-diabetic patients.
authors.affiliation: Division of Cardiology, Tokushima Red Cross Hospital, Komatsushima, Tokushima, Japan. ptcaman@tokushima-med.jrc.or.jp
authors.forename: Koichi
authors.initials: K
authors.lastname: Kishi
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Hiasa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tomokane
authors.forename: Kouji
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Riyo
authors.initials: R
authors.lastname: Ogura
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Miyajima
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Ohara
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Ogata
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Yuba
authors.forename: Naokli
authors.initials: N
authors.lastname: Suzuki
authors.forename: Takefumi
authors.initials: T
authors.lastname: Takahashi
authors.forename: Shinobu
authors.initials: S
authors.lastname: Hosokawa
authors.forename: Ryuji
authors.initials: R
authors.lastname: Otani
mesh_terms: D000368:Aged; D017225:Atherectomy, Coronary; D019917:Blood Vessel Prosthesis Implantation; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D048909:Diabetes Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012086:Reoperation; D015607:Stents; D016896:Treatment Outcome