Management of in-stent restenosis has become a significant challenge in interventional cardiology. The results of balloon angioplasty have been disappointing due to the high recurrence of restenosis at follow-vp. Debulking of the restenotic tissue within the stents using directional coronary atherectomy (DCA) may offer a therapeutic advantage. We report the immediate clinical and angiographic outcomes and long-term clinical follow-up results of 45 patients (46 lesions), mean age 63 +/- 12 years, 73% men, with ct mean reference diameter of 2.9 +/- 0.6 mm, treated with DCA for symptomatic Palmaz-Schatz in-stent restenosis. DCA was performed successfully in all 46 lesions and resulted In a postprocedural minimal luminal diameter of 2.7 +/- 0.7 mm and a residual diameter stenosis of 17 +/- 10%. There were no in-hospital deaths, Q-wave myocardial infarctions, or emergency coronary artery bypass surgeries. Four patients (9%) suffered a non-Q-wave myocardial infarction. Target lesion revascularization was 28.3% at a mean follow-vp of 10 +/- 4.6 months. Kaplan-Meier event-free survival (freedom from death, myocardial infarction, and repeat target lesion revascularization) was 71.2% and 64.7% at 6 and 12 months after DCA, respectively. Thus, DCA is safe and efficacious for the treatment of Palmaz-Schatz in-stent restenosis. It results in a large postprocedural minimal luminal diameter and a low rate of both target lesion revascularization and combined major clinical evens at follow-vp. (C) 1998 by Excerpta Medica, Inc.
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BETH ISRAEL MED CTR, DEPT CHEM, DIV CARDIOVASC, HARVARD THORNDIKE LAB, NEW YORK, NY 10003 USABETH ISRAEL MED CTR, DEPT CHEM, DIV CARDIOVASC, HARVARD THORNDIKE LAB, NEW YORK, NY 10003 USA
BAIM, DS
LEVINE, MJ
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BETH ISRAEL MED CTR, DEPT CHEM, DIV CARDIOVASC, HARVARD THORNDIKE LAB, NEW YORK, NY 10003 USABETH ISRAEL MED CTR, DEPT CHEM, DIV CARDIOVASC, HARVARD THORNDIKE LAB, NEW YORK, NY 10003 USA
LEVINE, MJ
LEON, MB
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BETH ISRAEL MED CTR, DEPT CHEM, DIV CARDIOVASC, HARVARD THORNDIKE LAB, NEW YORK, NY 10003 USABETH ISRAEL MED CTR, DEPT CHEM, DIV CARDIOVASC, HARVARD THORNDIKE LAB, NEW YORK, NY 10003 USA
LEON, MB
LEVINE, S
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BETH ISRAEL MED CTR, DEPT CHEM, DIV CARDIOVASC, HARVARD THORNDIKE LAB, NEW YORK, NY 10003 USABETH ISRAEL MED CTR, DEPT CHEM, DIV CARDIOVASC, HARVARD THORNDIKE LAB, NEW YORK, NY 10003 USA
LEVINE, S
ELLIS, SG
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BETH ISRAEL MED CTR, DEPT CHEM, DIV CARDIOVASC, HARVARD THORNDIKE LAB, NEW YORK, NY 10003 USABETH ISRAEL MED CTR, DEPT CHEM, DIV CARDIOVASC, HARVARD THORNDIKE LAB, NEW YORK, NY 10003 USA
ELLIS, SG
SCHATZ, RA
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BETH ISRAEL MED CTR, DEPT CHEM, DIV CARDIOVASC, HARVARD THORNDIKE LAB, NEW YORK, NY 10003 USABETH ISRAEL MED CTR, DEPT CHEM, DIV CARDIOVASC, HARVARD THORNDIKE LAB, NEW YORK, NY 10003 USA
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BETH ISRAEL MED CTR, DEPT CHEM, DIV CARDIOVASC, HARVARD THORNDIKE LAB, NEW YORK, NY 10003 USABETH ISRAEL MED CTR, DEPT CHEM, DIV CARDIOVASC, HARVARD THORNDIKE LAB, NEW YORK, NY 10003 USA
BAIM, DS
LEVINE, MJ
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BETH ISRAEL MED CTR, DEPT CHEM, DIV CARDIOVASC, HARVARD THORNDIKE LAB, NEW YORK, NY 10003 USABETH ISRAEL MED CTR, DEPT CHEM, DIV CARDIOVASC, HARVARD THORNDIKE LAB, NEW YORK, NY 10003 USA
LEVINE, MJ
LEON, MB
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BETH ISRAEL MED CTR, DEPT CHEM, DIV CARDIOVASC, HARVARD THORNDIKE LAB, NEW YORK, NY 10003 USABETH ISRAEL MED CTR, DEPT CHEM, DIV CARDIOVASC, HARVARD THORNDIKE LAB, NEW YORK, NY 10003 USA
LEON, MB
LEVINE, S
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BETH ISRAEL MED CTR, DEPT CHEM, DIV CARDIOVASC, HARVARD THORNDIKE LAB, NEW YORK, NY 10003 USABETH ISRAEL MED CTR, DEPT CHEM, DIV CARDIOVASC, HARVARD THORNDIKE LAB, NEW YORK, NY 10003 USA
LEVINE, S
ELLIS, SG
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机构:
BETH ISRAEL MED CTR, DEPT CHEM, DIV CARDIOVASC, HARVARD THORNDIKE LAB, NEW YORK, NY 10003 USABETH ISRAEL MED CTR, DEPT CHEM, DIV CARDIOVASC, HARVARD THORNDIKE LAB, NEW YORK, NY 10003 USA
ELLIS, SG
SCHATZ, RA
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h-index: 0
机构:
BETH ISRAEL MED CTR, DEPT CHEM, DIV CARDIOVASC, HARVARD THORNDIKE LAB, NEW YORK, NY 10003 USABETH ISRAEL MED CTR, DEPT CHEM, DIV CARDIOVASC, HARVARD THORNDIKE LAB, NEW YORK, NY 10003 USA