Efficacia a breve termine dell'associazione di aterotomia rotativa ad alta velocità ed angioplastica con palloncino nel trattamento delle lesioni situate sull'ostio di un ramo coronarico [Short-term efficacy of high speed rotational atherectomy with and balloon angioplasty in the treatment of lesions located at the ostium of a coronary branch]

In the treatment of branch-ostial lesions (BOL) balloon angioplasty (PTCA) is associated with suboptimal results and a higher complication rate. Rotational atherectomy (RA) before PTCA might improve results. This approach was used in 37 patients (mean age 62 +/- 10 years; 27 men, 10 women) with 42 BOL. Mean burr size was 1.7 +/- 0.3 mm; burr-artery ratio was 0.75 +/- 0.10. Procedural success was achieved in 39 (93%) BOL; the only major complication was a periprocedural myocardial infarction (CPKMB=58IU/ml). In 2 cases the stenosis was not crossed by the guidewire. Diameter stenosis (DS) decreased from 72 +/- 14% before RA to 30 +/- 12% after RA (p < 0.001) and 15 +/- 10% after PTCA (p < 0.001). All patients with a successful procedure underwent repeat angiography 24 hours DS was 18 +/- 15 (NS versus after PTCA); no lesion had DS > or = 50%. RA with adjunctive PTCA is a safe and effective treatment of BOL, with short-term stable results.