Long-term results of directional coronary atherectomy: Predictors of restenosis

Abstract

Six-month angiographic follow-up of patients who underwent directional coronary atherectomy during the 1st 3 years of our experience shows an overall restenosis rate of 32%, with lower rates in patients with a postatherectomy lumen diameter > or = 3 mm, cholesterol level < or = 200 mg/dl or a recent myocardial infarction. Few if any events relating to the site of atherectomy developed after the 1st year of follow-up.

Plaque Tissue Components Obtained from De Novo Lesions may Predict Restenosis after Directional Coronary Atherectomy

“…Deep arterial wall excision is not generally associated with an increased incidence of restenosis. 21,22) However, this was not supported by the results of another study in which the presence of internal elastic lamina and media in higher percentage of patients of restenosis.…”

Understanding and managing in-stent restenosis: a review of clinical data, from pathogenesis to treatment

“…In the pre-stent era it ranged between 32-55% of all angioplasties, and drop to 17-41% (8)(9)(10)(11) in the BMS era (12)(13)(14). A further step to reduce restenosis was undertaken with the advent of DES, with a reduction to numbers <10% (15,16).…”

Directional coronary atherectomy in intermediate sized vessels: Final results of the intermediate vessel atherectomy trial (IVAT)

“…The results of CAVEAT and CCAT all but eliminated DCA from consideration for catheter based revascularization of intermediate sized vessels. It has since been speculated, however, that the CAVEAT in-vestigators could have achieved even larger luminal diameters had they used larger devices and performed more extensive tissue removal [7,8], as has been safely performed in other, single-center studies [9,10]. It was shown in CAVEAT that immediate results are highly predictive of late angiographic results for both DCA and angioplasty, suggesting that a larger immediate luminal diameter might correlate with even better long-term results.…”