HIGH-SPEED ROTATIONAL ATHERECTOMY FOR CHRONIC TOTAL CORONARY OCCLUSIONS

Treatment of chronic total occlusions remains a limitation of percutan eous revascularization and is associated with lower immediate success and higher long-term restenosis rates compared to less severe stenoses . While part of the problem in dealing with total occlusions relates t o successfully passing a wire across the occluded segment, most chroni c occlusions contain large plaque burdens. Balloon dilatation sometime s fails to restore antegrade flow and often yields suboptimal angiogra phic results in these situations. Rotational atherectomy has proven us eful in treating calcified and diffusely-diseased vessels and appears attractive for debulking lesions with large atheromatous plaques. We r eport our experience using rotational atherectomy in treating chronic total occlusions. (C) 1996 Wlley-Liss, Inc.