[Binary restenosis post-cutting balloon ptca before stenting].
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.
Flores
Jesús Flores
JF
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.
Villada
José Antonio Palomo
JA
Ruiz
Enrique Bernal
EB
Hernández
Jaime Santiago
JS
Silvestre
Armando Montoya
AM
Sandoval
Raúl Astudillo
RA
Gallegos
Joel Estrada
JE
Velasco
Arturo Abundes
AA
Campa
Javier Farell
JF
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