PMID: 11315574Apr 24, 2001Paper

Treatment of stent restenosis using rotational atherectomy: mechanisms and results

Zeitschrift für Kardiologie
Peter W RadkeJ vom Dahl

Abstract

Restenosis after coronary stent implantation remains one of the major limitations of this treatment modality. At present, redilatation is considered the therapeutic option of choice for focal lesions; however, long restenotic lesions (> 10 mm) do not respond favourably. Despite the emerging concept of intracoronary radiation, encouraging acute procedural results are also reported for different debulking techniques (excimer laser angioplasty, directional coronary atherectomy, and rotational atherectomy, or rotablation). Rotablation has been studied most extensively with acute and long-term results published in a total of 500 patients. Experimental and first clinical data indicate favourable results for the rotablator as compared to balloon angioplasty alone for the treatment of in-stent restenosis. Data from the first two randomised clinical trials (ROSTER and A.R.T.I.S.T. trials) have now been published in abstract form, with conflicting results: whereas the monocenter ROSTER trial suggests a clinical benefit to patients treated by the rotablator, the multicenter A.R.T.I.S.T. trial including nearly 300 patients could not prove a benefit for the rotablator as compared to re-dilatation in patients with diffuse stent restenosis. C...Continue Reading

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