Three-year follow-up after rotational atherectomy for the treatment of diffuse in-stent restenosis: Predictors of major adverse cardiac events

Restenosis remains the major limitation of coronary stent implantation, esp ecially in diffuse forms of in-stent restenosis. In this study, rotablation (RA) with adjunct angioplasty of in-stent restenosis was performed in 84 p atients. Clinical follow-up and control angiography were obtained 6-month p ostprocedure, The rate of recurrent restenosis after rotablation for in-ste nt restenosis at 6-month angiographic follow-up was 45%, resulting in a rat e of major adverse cardiac events of 35%, At 3-year follow-up, the cumulati ve event-free survival rate was 57% for the entire population. The only pre dictor of MACE at 3-year clinical follow-up by multivariate logistic regres sion analysis was in-stent lesion length. RA for the treatment of diffuse i n-stent restenosis is thereby characterized by high procedural success rate s and recurrent angiographic restenosis in 45% of patients with diffuse les ions. Major adverse cardiac events occur most likely within the first 6 mon ths postprocedure, Three years after rotablation of in-stent restenosis, 43 % of patients had experienced at least one major adverse cardiac event. (C) 2001 Wiley-Liss, Inc.