title: Directional atherectomy facilitates the interventional procedure and leads to a low rate of recurrent stenosis in left anterior descending and left circumflex artery ostium stenoses: subgroup analysis of the FLEXI-CUT study.
abstract: OBJECTIVE
  To examine by retrospective analysis of data from the FLEXI-CUT monocentre registry whether atherectomy can effectively simplify complex stent implantation in ostial bifurcation lesions by reducing the procedure to stenting of the left anterior descending (LAD) or left circumflex (LCX) artery ostium alone.
  
  
  METHODS
  All patients who had been enrolled in the prospective FLEXI-CUT study (directional atherectomy with adjunctive balloon angioplasty) were retrospectively analysed on the basis of significant LAD or LCX ostial stenosis (>or= 70% stenosis) deriving from an undiseased left main stem. The primary combined end point was the rate of target lesion revascularisation (TLR) and binary restenosis; secondary end points were procedural success and major adverse cardiac events (MACE) at the six-month follow up.
  
  
  RESULTS
  Of 30 patients enrolled with significant LAD or LCX ostium stenosis, 29 were effectively treated with directional atherectomy (96.7% procedural success). All patients underwent single-vessel stenting procedures of solely the LAD or LCX ostium. At follow up, binary stenosis was 25% (6 of 24), TLR (angiographic plus clinical) 10.3% (3 of 29) and total MACE 6.9% (2 of 29).
  
  
  CONCLUSIONS
  Directional atherectomy with single-vessel stenting procedures facilitates the interventional treatment of LAD and LCX ostium stenosis, and leads to remarkably low TLR and binary stenosis at follow up.
authors.affiliation: Department of Cardiology, Ernst Moritz Arndt University Greifswald, Friedrich-Loeffler-Strasse 23b, D-17487 Greifswald, Germany. dahm@uni-greifswald.de
authors.forename: J B
authors.initials: JB
authors.lastname: Dahm
authors.forename: J
authors.initials: J
authors.lastname: Ruppert
authors.forename: S
authors.initials: S
authors.lastname: Hartmann
authors.forename: D
authors.initials: D
authors.lastname: Vogelgesang
authors.forename: A
authors.initials: A
authors.lastname: Hummel
authors.forename: S B
authors.initials: SB
authors.lastname: Felix
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000379:methods; D017225:Atherectomy, Coronary / Q000379:methods*; D023903:Coronary Restenosis / Q000517:prevention & control; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome