title: Effect of rotational atherectomy on the coronary microcirculation in patients with angina pectoris.
abstract: OBJECTIVE
  The coronary microcirculation can be impaired by ablated debris just after a rotational atherectomy procedure, but the specific effects of rotablation on the microcirculation have not been investigated. The present study examined the effects of rotational atherectomy on the coronary microcirculation by analyzing coronary flow reserve (CFR) and the component parameters of the coronary flow-pressure loop.
  
  
  METHODS
  This study included 31 patients with angina pectoris who underwent stent implantation after rotational atherectomy and with < 50% diameter stenosis at 6-month follow-up (i.e. without clinical restenosis). The CFR, the flow-pressure slope index (FPSI) and zero-flow pressure were measured using the FloWire Doppler guidewire in both treated and untreated reference vessels without stenosis immediately after and on 6 months from the rotational atherectomy procedure.
  
  
  RESULTS
  CFR and FPSI in the treated vessels were significantly lower than in the untreated reference vessels without stenosis just after rotational atherectomy (CFR: 2.1 +/- 0.5 vs 2.6 +/- 0.7, p < 0.05; FPSI: 1.61 +/- 0.8 vs 2.35 +/- 0.9 cm/sec/mmHg, p < 0.05), but no significant differences were observed in CFR or FPSI between these same sets of arteries at follow-up. There was also a significant correlation between the extent of attenuation of CFR and total ablation time (r = - 0.54, p < 0.01).
  
  
  CONCLUSIONS
  Rotational atherectomy attenuates CFR by reducing coronary artery conductance, probably due to coronary microvessel obstruction with the debris ablated during the procedures of rotational atherectomy.
authors.affiliation: Department of Cardiology, Showa General Hospital, Tokyo.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Tanaka
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Akiko
authors.initials: A
authors.lastname: Ishihara
authors.forename: Kohei
authors.initials: K
authors.lastname: Yano
authors.forename: Toshikatsu
authors.initials: T
authors.lastname: Sada
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kira
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000503:physiopathology* / Q000601:surgery*; D017225:Atherectomy, Coronary; D003326:Coronary Circulation / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D015607:Stents