REDUCED DISTAL EMBOLIZATION WITH TRANSLUMINAL EXTRACTION ATHERECTOMY COMPARED TO BALLOON ANGIOPLASTY FOR SAPHENOUS-VEIN GRAFT DISEASE

Extraction atherectomy utilizes suction aspiration as an attempt to li mit distal emboli during atherectomy. We sought to test the hypothesis that extraction atherectomy produces less distal embolization than ba lloon angioplasty when treating saphenous vein grafts. Among 163 conse cutive, nonrandomized patients, 103 patients underwent transluminal ex traction catheter (TEC)(R) atherectomy with or without adjunctive ball oon angioplasty, and 60 patients had conventional balloon angioplasty. Both groups showed comparably high procedural success rates (TEC 90.3 %, angioplasty 83.3%, P = NS). TEC cases had a significantly lower inc idence of angiographic distal embolization, compared with angioplasty (3.9% vs. 16.7%, P = 0.005). In cases with angiographic evidence of th rombus in the grafts. TEC maintained a significantly lower incidence o f distal embolization than angioplasty (5.6% vs. 31.8%, P = 0.004). Th ere were no statistical differences between the two groups regarding t he incidence of other procedure-related complications, including death , myocardial infarction, or emergency coronary artery bypass grafting. TEC atherectomy appears to have a significantly lower incidence of di stal embolization than balloon angioplasty when treating saphenous vei n grafts, particularly in the presence of angiographically apparent th rombus. (C) 1996 Wiley-Liss, Inc.