Optimal burr and adjunctive balloon sizing reduces the need for target artery revascularization after coronary mechanical rotational atherectomy

The American Journal of Cardiology
B M KaplanW W O'Neill

Abstract

We analyzed the effect of differing burr and balloon sizes during mechanical rotational atherectomy on the need for target vessel revascularization at 6 months. The ideal burr/artery ratio and adjunctive balloon/artery ratio for optimizing acute luminal results and minimizing restenosis is unknown. Six-month clinical follow-up was obtained in 311 patients (339 lesions) treated with rotational atherectomy from August 1993 to September 1994, to determine whether procedural results or technique were related to the need for target vessel revascularization. Target vessel revascularization, defined as repeat percutaneous intervention or bypass surgery within 6 months after rotational atherectomy, occurred in 19% of patients. Larger burr/artery ratios, defined as the final burr size divided by the reference artery size, were correlated with decreased postatherectomy diameter stenosis (p <0.009) and decreased final diameter stenosis (p <0.03). However, there was no statistical association between postatherectomy or final diameter stenosis with need for revascularization (p = not significant [NS]). The need for revascularization was lowest for burr/artery ratio between 0.6 to 0.85 (15%) versus burr/artery <0.6 or >0.85 (25%) (p <0.04). ...Continue Reading

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Citations

Oct 18, 2003·Journal of Interventional Cardiology·Akiyoshi TsubokawaShun-Ichi Tamaki
Mar 5, 2004·International Journal of Cardiology·Tadayuki UetaniTatsuaki Matsubara
Apr 27, 1999·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Y KobayashiA Colombo
Apr 29, 2006·Journal of Cardiovascular Medicine·Gennaro SardellaFrancesco Fedele
Aug 31, 1999·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·R S KieszR L Chilton
Apr 27, 1999·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·R M BersinP J Fitzgerald
Jul 12, 2017·Journal of the Chinese Medical Association : JCMA·Ta-Jung WangTse-Min Lu
Apr 6, 2004·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Paolo RubartelliEzio Bramucci

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