Efficacy of stenting after rotational atherectomy for ostial LAD and ostial LCX stenosis in patients with diabetes.
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.
Kishi
Koichi
K
Division of Cardiology, Tokushima Red Cross Hospital, Komatsushima, Tokushima, Japan. ptcaman@tokushima-med.jrc.or.jp
Hiasa
Yoshikazu
Y
Tomokane
Takeshi
T
Yamaguchi
Kouji
K
Ogura
Riyo
R
Miyajima
Hitoshi
H
Ohara
Yoshikazu
Y
Ogata
Tatsuro
T
Yuba
Kenichiro
K
Suzuki
Naokli
N
Takahashi
Takefumi
T
Hosokawa
Shinobu
S
Otani
Ryuji
R
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