[High frequency rotational angioplasty (rotablation) after unsuccessful balloon dilatation]

From April 1991 to March 1992, 2442 balloon dilatations were carried out. In 36/2442 patients (1.5%), a high-degree coronary stenosis or a coronary occlusion could be passed with a guide wire, but not with a balloon catheter or a recanalization catheter. In 32 of these 36 cases, the conventional coronary guide wire could be exchanged with the 0.009 inch guide wire required for rotational angioplasty. A sufficient increase in stenosis diameter could be attained by rotablation alone in 15 cases. A balloon dilatation was carried out after the rotablation in 17 cases. In one case, implantation of a stent was necessary in addition. The mean degree of stenosis was reduced from 95 +/- 10 to 33 +/- 6%. Thus, high-grade coronary stenoses and occlusions which cannot be passed with a balloon catheter, can be treated successfully with rotablation in a high percentage of cases.