Percutaneous coronary rotational angioplasty: preliminary clinical and quantitative imaging results

To determine anatomical and functional changes within the first 24 hours after percutaneous coronary rotational angioplasty (PCRA-ROTABLATOR, Biophysics International, USA), we studied 5 patients (4 men) with a mean age of 55 years (range 52-59) using quantitative coronary angiography, coronary flow reserve from digitized coronary angiograms, quantitative left ventricular angiography, and 99mTechnetium-MIBI SPECT imaging before PCRA, immediately after, and 24 hours after. The minimal luminal diameter and obstruction area showed a moderate increase immediately after PCRA, with a substantial further improvement after 24 hours. The mean coronary flow reserve before PCRA and 24 hours after (1.65 +/- 0.31 vs. 1.81 +/- 0.37; p = NS) remained unchanged. Although the global ejection fraction showed slight impairment immediately after PCRA, this was restored 24 hours later. Only the contribution to regional ejection fraction in the regions supplied by the treated coronary artery attributed to the decrease of global ejection fraction. Before and after PCRA, Tc-99m MIBI tomography performed at rest revealed no perfusion defects in the myocardial regions related to the coronary arteries undergoing the intervention.