Cutting balloon angioplasty and stenting for aorto-ostial lesions.

A. S. Kurbaan, P. A. Kelly, U. Sigwart

Department of Invasive Cardiology, Royal Brompton Hospital/National Heart and Lung Institute, London, United Kingdom.

OBJECTIVE: To investigate the use of a cutting balloon to overcome aorto-ostial lesions before stent implantation and thereby reduce the restenosis rate. DESIGN: Observational follow up study. SETTING: Tertiary referral centre. PATIENTS: Eight patients (two female, six male) aged 58.2 (SD 10.1) years with Canadian Cardiovascular Society (CCS) grade II-IV angina were recruited. They each had a single target lesion (three in native coronaries, five in vein grafts). INTERVENTION AND RESULTS: After high pressure angioplasty (18 (3.8) bar), there was only a small reduction in the luminal stenosis, from 82 (9)% to 68 (10)%, as assessed by on line quantitative coronary angiography. However, using the cutting balloon there was a marked reduction in the luminal stenosis to 44 (15)%, facilitating stent insertion. Subsequent high pressure dilatation resulted in a final stenosis of 10 (7)%. At 6 (2) months' follow up the marked symptomatic improvement, to CCS angina grade 0-II, was maintained and there were no further cardiac events or interventions. CONCLUSION: Cutting balloon angioplasty followed by stent insertion is a feasible technique for the treatment of aorto-ostial lesions, meriting further investigation.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Iakovou, I., Ge, L., Colombo, A. (2005). Contemporary Stent Treatment of Coronary Bifurcations. J Am Coll Cardiol 46: 1446-1455 [Abstract] [Full Text]  
• Adamian, M., Colombo, A., Briguori, C., Nishida, T., Marsico, F., Di Mario, C., Albiero, R., Moussa, I., Moses, J. W. (2001). Cutting balloon angioplasty for the treatment of in-stent restenosis: a matched comparison with rotational atherectomy, additional stent implantation and balloon angioplasty. J Am Coll Cardiol 38: 672-679 [Abstract] [Full Text]  
• Engelke, C., Morgan, R. A., Belli, A.-M. (2002). Cutting Balloon Percutaneous Transluminal Angioplasty for Salvage of Lower Limb Arterial Bypass Grafts: Feasibility. Radiology 223: 106-114 [Abstract] [Full Text]