Related Experiment Video

Updated: Feb 5, 2026

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
04:30

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

Published on: May 14, 2013

26.3K

Rotational Atherectomy Combined with Drug Coated-Balloons for in-Stent Restenosis

Matthew Allan1, Dominic Vickers2, Mark Pitney3

  • 1Prince of Wales Hospital, Sydney, Australia; The Sutherland Hospital, Sydney, Australia; The University of New South Wales, Sydney, Australia.

Cardiovascular Revascularization Medicine : Including Molecular Interventions
|September 16, 2018
PubMed

Insights

Rotational atherectomy before drug-coated balloon angioplasty is a safe option for challenging coronary in-stent restenosis. This novel approach showed feasibility in selected cases, with no major complications during follow-up.

Area of Science:

  • Interventional Cardiology
  • Vascular Medicine
  • Cardiovascular Interventions

Background:

  • Refractory coronary in-stent restenosis is a persistent clinical challenge.
  • Current treatments like drug-coated balloons and drug-eluting stents have limitations.
  • Novel strategies are needed for complex in-stent restenosis cases.

Purpose of the Study:

  • To evaluate the safety and effectiveness of rotational atherectomy followed by drug-coated balloon angioplasty.
  • To assess this novel approach for challenging coronary in-stent restenosis.
  • To determine the feasibility of lesion debulking prior to angioplasty.

Main Methods:

  • Retrospective analysis of procedural and registry data.
  • 26 patients with 43 coronary in-stent restenosis lesions treated.
  • Rotational atherectomy followed immediately by drug-coated balloon angioplasty.
  • Mean follow-up duration of 19 months.

Main Results:

  • 100% lesion success with no major procedural complications.
  • No deaths or myocardial infarctions during follow-up.
  • Target lesion revascularisation in 6 patients; target vessel revascularisation in 8 patients.
  • Previous failures of drug-coated balloon angioplasty without debulking were overcome in some cases.

Conclusions:

  • Lesion debulking with rotational atherectomy before drug-coated balloon angioplasty is feasible for selected in-stent restenosis.
  • This combined approach offers a potential treatment option for complex cases.
  • Further research is required to compare efficacy against conventional treatments.
Abstract

Keywords:
DebulkingDrug coated balloonIn-stent restenosisRotational atherectomy

More Related Videos

Fabrication of Small Caliber Stent-grafts Using Electrospinning and Balloon Expandable Bare Metal Stents06:55

Fabrication of Small Caliber Stent-grafts Using Electrospinning and Balloon Expandable Bare Metal Stents

Published on: October 26, 2016

9.5K
Human Internal Mammary Artery IMA Transplantation and Stenting: A Human Model to Study the Development of In-Stent Restenosis05:37

Human Internal Mammary Artery IMA Transplantation and Stenting: A Human Model to Study the Development of In-Stent Restenosis

Published on: May 9, 2012

11.8K

Related Concept Videos

Combined Effects of Drugs: Synergism01:27

Combined Effects of Drugs: Synergism

Synergism is a useful mechanism where combining two or more drugs is more effective than each constituent used alone. Such combinations are also called supra-additive interactions. The drugs collectively enhance the final therapeutic effect by acting on different targets. Another advantage is that the low dose of each constituent drug is sufficient to achieve the desired effect. This helps reduce the duration of therapy and lower the adverse effects of these drugs.
Such synergistic combinations...
6.9K
Combined Effects of Drugs: Antagonism01:30

Combined Effects of Drugs: Antagonism

The combined effects of drugs can result in various interactions, of which an important type is antagonism. Antagonism is a mechanism where one drug inhibits or counteracts the effects of another drug. Antagonism can occur through various means, including receptor binding, allosteric modulation, functional interaction, chemical reactions, and pharmacokinetic processes.
The most common type is receptor antagonism, where one drug acts as an antagonist to block the effects of another drug by...
11.7K
Kinematic Equations for Rotation01:30

Kinematic Equations for Rotation

In mechanics, when one observes a rigid body in rotational motion with constant angular acceleration, it is possible to establish equations for its rotational kinematics. This process resembles how linear kinematics are dealt with in simpler motion studies.
For instance, imagine a point A on a rigid body engaged in circular motion. The translational velocity of this particular point can be calculated by taking the time derivatives of the displacement equation, which essentially measures the...
819
Rotation of Asymmetric Top01:11

Rotation of Asymmetric Top

By definition, a spherically symmetric body has the same moment of inertia about any axis passing through its center of mass. This situation changes if there is no spherical symmetry. Since most rigid bodies are not spherically symmetric, these require special treatment.
The relationship between the angular momentum of any rigid body and its angular velocity, both of which are vectors, involves the moment of inertia. The moment of inertia is a scalar quantity only for spherically symmetric...
1.6K
Pinching-off of Coated Vesicles01:32

Pinching-off of Coated Vesicles

Vesicle budding is orchestrated by distinct cytosolic proteins such as adaptor proteins, coat proteins, and GTPases. To initiate vesicle budding, membrane-bending proteins containing crescent-shaped BAR domains bind to the lipid heads in the bilayer and distort the membrane to form a protein-coated vesicle bud. Adaptors proteins such as AP2 for clathrin-coated vesicles can nucleate on the deformed membrane. Finally, coat proteins such as clathrin or COPI and COPII assemble into a coat forming...
4.2K
Clathrin Coated Vesicles01:12

Clathrin Coated Vesicles

Clathrin-coated vesicles use endocytosis to transport receptors and lysosomal hydrolases from the Golgi to the lysosome in the late secretory pathway. Clathrin-mediated endocytosis was the first described endocytic process, and Clathrin-coated vesicles remain one of the most well-studied transport vesicles. The molecular machinery that generates clathrin-coated vesicles comprises over 50 proteins that precisely coordinate vesicle formation. Cell surface receptors concentrated in indented sites...
9.4K