ROTATIONAL ATHERECTOMY (ROTABLATOR) FOR P ERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY

Background: The use of Rotablator(R) in percutaneous transluminal coro nary angioplasty attempts to reduce the atheromatous plaque abrading i t and fragmenting the parietal calcium of the artery. Aim: To report o ur experience with the use of Rotablator. Patients and methods: Rotati onal atherectomy was performed in 189 patients aged 60.8 +/- 11 years (154 men). The clinical indication for the procedure was chronic angin a in 22%, unstable angina in 44%, myocardial infarction in 21%, silent angina in 7% and re-stenosis in 6%. One hundred seventy seven patient s were followed for a mean of 15.9 +/- 6.3 months. Results: Two hundre d thirty six stenoses in 215 coronary arteries were treated with at 98 .7% angiographic success rate. One patient had a Q infarction and no p atient died or required emergency surgery. Fourteen patients had rises in CK MB enzymes (non Q infarction). Three patients had a pseudoaneur ism and three had bleedings that required transfusion. Of the followed patients, 33 had a clinically suspected re-stenosis, that was angiogr aphically confirmed in 23. Cardiac mortality was 2.3%. Seventy nine pe rcent of patients had an evolution without angina or coronary events. Conclusions: Percutaneous transluminal coronary angioplasty with the u se of Rotablator had a high immediate success rate and a low incidence of complications. The clinical evolution of patients has been favorab le with a low incidence of mortality and ischemic events.