1 / 14

Does Adjuvant Stenting After Coronary Rotablation Affect Restenosis Rate !

Does Adjuvant Stenting After Coronary Rotablation Affect Restenosis Rate !. Layth A. Mimish, M. Bakhshi, J. Buraiki, A. Patel, K. Niazi, M. E. Fawzy, B. Dajani, B. Dunn K.F.S.H. & R.C. Riyadh, Saudi Arabia. The Goal of The Study.

skah
Télécharger la présentation

Does Adjuvant Stenting After Coronary Rotablation Affect Restenosis Rate !

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Does Adjuvant Stenting After Coronary Rotablation Affect Restenosis Rate ! Layth A. Mimish, M. Bakhshi, J. Buraiki, A. Patel, K. Niazi, M. E. Fawzy, B. Dajani, B. Dunn K.F.S.H. & R.C. Riyadh, Saudi Arabia

  2. The Goal of The Study • Retrospective analysis of all cases who underwent conary revascularization with high speed rotational atherectomy from October 1993 - October 1997 • Comparison of angiographic restenosis rates between patients who had HSRA +ballooning, and those who had additional stenting at the end of the procedure

  3. Indications of Rotablation • Calcification in the coronary lesion on floroscopy • Inability to dilate with high atmospheric pressures • Inability to cross the lesion with 1.5 mm balloon • Participation in the Effect of Debulking on Restenoses Study (EDRESS)

  4. Indications of Stenting • Coronary dissection unresolved by prolonged balloon inflaton • Residual stenosis more than 40% • Part of the EDRESS protocol

  5. Rotablation • 10,000 U IV Heparin before procedure • Small Burr Size with larger Burrs if needed • Multiple short passes • No significant drop in RPM • Multiple doses of I.C. NTG and Verapamil • Ballooning in all cases

  6. Stenting • Ticlopidine 250 mg • ACT 250-300 • 14-16 Atmospheres deployment pressure • Multiple post deployment angiographic views • Sheath removal within 3 hrs. • Ticlopidine BID, ASA for 1 month

  7. Demographic Data • October 1993-1997, 183 cases • 147 males and 36 females • Mean age 57+-11 years • LAD 102, Diagonal 2, Intermediate 2, Circumflex/OM 27, RCA 50 cases • Lesion type B-C 84% • Stenting in 72 cases

  8. Rotablation • Mean Burr Size 1.9 +- 0.3 mm • Mean number of passes 4+-2 • Ablation time 99+-59 sec • All lesion were dilated with a balloon post HSRA • Success rate 95%

  9. No. 109 Age 58.5+-10 M/F 82/27 Hx MI 55/109 QMI 40/55 Hx PTCA 40/109 73 55.3+-11 63/10 48/73 43/48 11/73 Demographic &clinical dataRotablation Rota+Stenting

  10. LAD 64/109 36/73 Cx/OM 16/109 8/73 RCA 24/109 27/73 Total Occlusion 22/109 9/73 Size 2.9+-0.5 3.2+-0.3 Type A 24 29 Type B 76 24 Type C 9 20 Demographic &clinical dataRotablation Rota+Stenting

  11. Burr size 1.8+-0.3 No. Burrs 1.2+-0.5 No. Passes 3.5+-1.7 Ablation 84+-46 Ca ++ 69 Failed Balloon 9 2.1+-0.3 1.2+-0.5 3.5+-1.7 126+-63 26 3 Demographic &clinical dataRotablation Rota+Stenting

  12. Success 101(93%) Failure 8 Death 2 (1.8%) Acute MI 2 CABG 4 Dissection 17 Non QMI 3 72(98.6%) 3 0 0 1 6 0 Demographic &clinical dataRotablation Rota+Stenting

  13. 6 Months Angiographic follow up • Available on 90% of patients who completed 6 months after the procedure • Restenoses in the total group was 38.7% • Restenoses in the stented group was 34.3% • Restenoses in the non-stented group was 42.5%

  14. Conclusion • There was 12.9% reduction in restenoses in stented group • Total numbers were small • Mean vessel size was larger than average • Restenoses remains high even with stenting

More Related