Rotational atherectomy or balloon angioplasty in the treatment of intra-stent restenosis: BARASTER multicenter registry

The BARASTER registry was formed to evaluate the initial success and long-t erm results of rotational atherectomy in the management of in-stent resteno sis. Rotational atherectomy was used in 197 cases of in-stent restenosis: 4 6 with stand-alone rotational atherectomy or at most 1 atmosphere of balloo n inflation (Rota strategy), and 151 with rotational atherectomy and adjunc tive balloon angioplasty <1 atmosphere (Combination strategy). These were c ompared with 107 episodes of in-stent restenosis treated with balloon angio plasty alone. In this observational study, the use of Combination therapy w as associated with a slightly higher initial success rate (95% vs. 87% with the Rota strategy and 89% with Balloons, P = 0.08). There was a reduction in one year clinical outcomes (death, myocardial infarction or target lesio n revascularization) in the combination group (38% vs. 60% with Rota and 52 % with balloons, P = 0.02). These data support a benefit of the strategy of debulking with rotational atherectomy followed by adjunctive balloon angio plasty, in the management of in-stent restenosis. Cathet Cardiovasc. Interv ent. 51:407-413, 2000 (C) 2000 Wiley-Liss, Inc.