Long-Term Clinical Follow-up after Rotational Atherectomy and Plain Old Balloon Angioplasty for the Treatment of Coronary Stent Restenosis

Lee, Sang Hyun; Jeong, Myung Ho; Yang, Bo Ra; Lim, Sang Yup; Kim, Weon; Kim, Joo Han; Park, Ok Young; Park, Woo Suk; Ahn, Young Keun; Cho, Jeong Gwan; Park, Jong Chun; Kang, Jung Chaee

Abstract

BACKGROUND AND OBJECTIVES
Since 1987, coronary stents have changed the pattern of practice of interventional cardiology, by reducing the complications and improving the clinical outcomes. However, coronary stent restenosis still remains a significant clinical problem in the field of interventional cardiology. The aim of this trial was to compare the clinical efficacy of a rotational atherectomy (ROTA), with that of a plain old balloon angioplasty (POBA), in patients with coronary stent restenosis.
SUBJECTS AND METHODS
One hundred and three patients (men 80, 58.4+/-10.3 years of age), diagnosed with coronary stent restenosis, at Chonnam National University Hospital, between January 1999 and December 2000, were analyzed. The clinical end-points were the occurrence of major adverse cardiac events (MACE): death, myocardial infarction and target lesion revascularization (TLR) during the one-year clinical follow-up.
RESULTS
The baseline clinical and angiographic characteristics were similar between the two groups. Before the percutaneous coronary intervention (PCI), the diameter of stenosis of the POBA and ROTA groups were 81.9+/-14.0 and 82.9+/-10.0%, respectively, which decreased to 25.5+/-15 and 22.7+/-12% after treatment. At the one-year clinical follow-up, the TLR rates were 7.0 and 6.3% in the POBA and ROTA groups, respectively. The MACE results were not different between the two groups (7.0 and 9.4% in the POBA and ROTA groups, respectively).
CONCLUSION
There was no significant long-term clinical benefit of a rotational atherectomy prior to a POBA, compared with a POBA alone, for the treatment of coronary stent restenosis.