Detailed clinical and angiographic analysis of transluminal extraction coronary atherectomy for complex lesions in native coronary arteries

The purpose of this study was to describe the results of transluminal extraction coronary atherectomy in native coronary arteries. Transluminal extraction coronary atherectomy was approved by the Food and Drug Administration for use in native coronary arteries and vein grafts. Between December 1988...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 1995-03, Vol.25 (4), p.848-854
Main Authors: Safian, Robert D., May, Melissa A., Lichtenberg, Anne, Schreiber, Theodore L., Pavlides, Gregory, Meany, Thomas B., Grines, Cindy L., O'Neill, William W.
Format: Article
Language:English
Subjects:
Aged
Atherectomy, Coronary - adverse effects
Biological and medical sciences
Chi-Square Distribution
Constriction, Pathologic - diagnostic imaging
Constriction, Pathologic - surgery
Coronary Angiography
Coronary Disease - diagnostic imaging
Coronary Disease - surgery
Female
Follow-Up Studies
Humans
Male
Medical sciences
Middle Aged
Multivariate Analysis
Recurrence
Regression Analysis
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the heart
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Summary:The purpose of this study was to describe the results of transluminal extraction coronary atherectomy in native coronary arteries. Transluminal extraction coronary atherectomy was approved by the Food and Drug Administration for use in native coronary arteries and vein grafts. Between December 1988 and July 1992, transluminal extraction coronary atherectomy was performed in 181 native coronary arteries in 175 patients. A detailed angiographic and clinical assessment was performed. Quantitative angiography (mean ± SD) revealed an increase in minimal lumen diameter from 1.0 ± 0.6 mm before to 1.3 ± 0.7 mm after atherectomy, to 2.1 ± 0.8 mm after final treatment (p < 0.001), corresponding to a diameter stenosis of 70 ± 16%, 61 ± 21% and 36 ± 21%, respectively (p < 0.001). Final procedural success (final diameter stenosis 50%) of 61%. Transluminal extraction coronary atherectomy is limited by a modest degree of lumen enlargement, frequent need for adjunctive angioplasty and a high restenosis rate. For complex lesions in native coronary arteries, transluminal extraction coronary atherectomy appears to offer no advantage over conventional balloon angioplasty.
ISSN:0735-1097
1558-3597
DOI:10.1016/0735-1097(94)00505-K