Influence of residual stenosis in determining restenosis after cutting balloon angioplasty

The cutting balloon is a new device for coronary angioplasty, which, by the combination of incision and dilatation of the plaque, is believed to minim ize arterial wall trauma, the neoproliferative response, and subsequent res tenosis. In this study, we sought to determine predictors of the restenosis using this technique, seventy-seven patients underwent successful coronary angioplasty with cutting balloon alone. In 67 of these patients (87%), we performed a control angiogram at 6-month follow-up. Pre-, post-, end late a ngiographic results were evaluated by quantitative coronary analysis. Clini cal and angiographic variables were correlated with restenosis as a binary variable and a continuous variable (late loss and late minimum luminal diam eter). Univariate analysis showed that the immediate postprocedure minimum luminal diameter (MLD) was smaller in the restenotic group (defined as MLD > 50% by quantitative coronary angiography) than in the nonrestenotic group (1.90 +/- 0.47 mm vs. 2.19 +/- 0.56 mm, P < 0.05). In addition, the immedi ate percentage of stenosis was higher in the restenotic group than in the n onrestenotic group (37% +/- 10% vs. 27% +/- 11%, P < 0.003). Multivariate a nalysis identified the immediate postcutting balloon percentage of stenosis as an independent determinant of binary restenosis (P < 0.008). When reste nosis was defined as a continuous variable, the immediate postprocedure MLD was an independent predictor of late loss (P < 0.02) and of late MLD (P < 0.0002). No clinical, preprocedure angiographic, or technical variables tes ted were associated with restenosis. The degree of postprocedural residual stenosis after cutting balloon angioplasty is predictive of late restenosis . (C) 2000 Wiley-Liss, Inc.