title: [Binary restenosis post-cutting balloon ptca before stenting].
abstract: The goal of the study is to describe our experience in percutaneous transluminal coronary angioplasty with cutting balloon, evaluating the immediate and mid-term outcomes. The cutting balloon is a device used as a strategy to promote plaque rupture and to allow for its distribution.
  
  
  METHODS
  This is a descriptive study to evaluate the clinical and angiographic restenosis rate (Binary restenosis). Patients with incomplete clinical data were excluded. From January 2003 to June 2004, 1,300 PTCA with stent were made; we selected a group of 39 patients in whom the cutting balloon was used (3.3%). Average age was 60.4+/-9.2 years. There were 32 men (80%) and 8 women (20%). Diabetes Mellitus in 10 (25%), dyslipidemia in 18 (45%), systemic hypertension in 22 (55%), smoking in 22 (55%). The indication for coronary angiography was stable angina in 21 (52.5%), unstable angina in 15 (37.5%), acute myocardial infarction without ST segment elevation in 3 (7.5%).
  
  
  RESULTS
  We treated 45 lesions: 4 (8.8%) main left, 24 (53.3%) anterior descending, 7 (15.5%) circumflex obtuse, 2 (4.4%) marginal, 8 (17.7%) right coronary. The average lesion severity before treatment was 88.8%+/-11. Lesions encountered corresponded to type B1 in 1 (2.2%), B2 in 22 (48.8%), and C in 22 (48.8%). The average lesion length was 19 mm+/-5.8 mm. The average vessel diameter was 3.6 mm +/-0.46 mm. We achieved a clinical follow-up of 100%. We performed angiographic control in 32 patients (71.1%) to evaluate instent restenosis, with an average follow-up of 7.6+/-3 months. Clinical and angiographic restenosis corresponded to 25 and 31.25% respectively.
  
  
  RESULTS
  Two (6.2%) patients presented complications; one died because of coronary perforation of the right coronary artery with pericardial effusion and tamponade.
  
  
  CONCLUSIONS
  The cutting balloon is a useful device for the management of complex lesions (B2 and C) but the restenosis rate with this device is similar to the one obtained with PTCA and stenting. So we do not recommend it for rutine use.
authors.affiliation: Servicio de Hemodinamia, Jesús Flores Flores. Hospital de Cardiología del Centro Medico Nacional Siglo XXI. IMSS, Mexico, D.F. Av. Cuauhtémoc Núm. 330. Col. Doctores 06725 México, D.F.
authors.forename: Jesús Flores
authors.initials: JF
authors.lastname: Flores
authors.forename: José Antonio Palomo
authors.initials: JA
authors.lastname: Villada
authors.forename: Enrique Bernal
authors.initials: EB
authors.lastname: Ruiz
authors.forename: Jaime Santiago
authors.initials: JS
authors.lastname: Hernández
authors.forename: Armando Montoya
authors.initials: AM
authors.lastname: Silvestre
authors.forename: Raúl Astudillo
authors.initials: RA
authors.lastname: Sandoval
authors.forename: Joel Estrada
authors.initials: JE
authors.lastname: Gallegos
authors.forename: Arturo Abundes
authors.initials: AA
authors.lastname: Velasco
authors.forename: Javier Farell
authors.initials: JF
authors.lastname: Campa
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome