Efficacy of directional coronary atherectomy before stent implantation forcoronary ostial lesions

We evaluated stent implantation following directional coronary atherectomy (DCA) for coronary ostial lesions. The subjects were 27 patients (27 lesion s) who underwent stent deployment after DCA, and 47 patients (47 lesions) w ho underwent stent deployment atone as the control group. There were no dif ferences in numbers of lesions with multi-vessel disease, left anterior des cending artery lesions, de novo lesions or reference vessel diameters in th e two groups. The percent diameter stenosis after stent implantation was lo wer in the DCA-stent group than in the stent-alone group (9 +/- 10% versus 17 +/- 14%, respectively; p < 0.01). The initial procedural success rate wa s 92.6% in the DCA-stent group and 91.4% in the stent-alone group. The init ial clinical success rate was 100% in the DCA-stent group and 95.7% in the stent-alone group. The restenosis rate was lower in the DCA-stent group (20 % versus 43% in the stent-alone group). This study showed that debulking by DCA before stenting is more effective compared to stenting alone.