Comparison of quantitative coronary angiographic results after directional coronary atherectomy and balloon angioplasty of protected left main coronary stenosis

Abstract

We compared the angiographic and clinical outcomes after directional coronary atherectomy (DCA, 13 patients) with those after conventional balloon angioplasty (BA, 21 patients) in patients with protected left main coronary artery stenosis. The initial success rate was 100% in the DCA group and 81% (17 of 21) in the BA group. Restenosis was present in 2 of 11 patients in the DCA group and 9 of 16 patients in the BA group (18% vs. 56%, P < 0.05). DCA and BA improved a minimal lumen diameter. The initial gain after DCA was greater than that after BA. At follow‐up, the minimal lumen diameter was larger and the percentage diameter stenosis was smaller in the DCA group than in the BA group. The late loss and loss index were equivalent in both groups. Compared with conventional BA, DCA in protected left main coronary artery stenosis is associated with a higher angiographic success rate and provides a wider luminal diameter with reduced incidence of restenosis. Cathet. Cardiovasc. Diagn. 44:138–141, 1998. © 1998 Wiley‐Liss, Inc.

Iatrogenic left main coronary artery thrombosis during percutaneous coronary intervention

“…During diagnostic angiographic procedures or percutaneous coronary angioplasty-stenting of the other coronary arteries, the overall risk for a complication related to the left main coronary artery (LMCA) is low; however, if such complications occur, they tend to be life-threatening and contribute to a large part of the total catheter-related mortality [1].…”

Acute and spontaneous coronary thrombosis in non-culprit artery during percutaneous coronary intervention in myocardial infarction with ST-segment elevation: A “shocking” case

“…Percutaneous coronary intervention (PCI) restores a TIMI grade flow 3 in > 90% of patients [2]. However, STEMI patients have a high risk of intraprocedural thrombotic events (IPTEs) because of elevated thrombotic burden and prothrombotic milieu during the ischemic event [3]. IPTEs occur more frequently in patients with STEMI than in those with unstable angina or non-STEMI and are associated with mortality, bleeding and major adverse cardiac events (MACE) [4].…”

Percutaneous treatment of left main disease: Keys to success

“…These new interventional tools have been designed to treat specific types of coronary lesions and to optimize the acute gain in lumen size. Yasuda et al [8] have shown retrospectively that debulking with DCA alone or in conjunction with PTCA has a higher initial success rate and lower restenosis rate than PTCA alone. Stenting of left main lesions has also been shown to improve short-and long-term outcomes [6,7].…”

“…Yasuda et al [8] present a retrospective analysis of protected left main lesions; 13 patients were treated with DCA compared to 21 patients with conventional PTCA. A higher initial success rate was achieved with DCA compared to PTCA (100 vs. 81%).…”