[Value of rotational ablation in reopening chronic coronary artery occlusion]

Previous studies, including our own prospective study (634 patients), on chronic coronary artery occlusion demonstrated the highest success rate in reopening by primary use of conventional guidewire technique. The present prospective randomized study in 124 patients investigates the role of high-speed rotational angioplasty after primary guidewire-recanalization in comparison to sequential PTCA. Early results were described by analyzing the residual degree of stenosis, early dissection, stabile dissection at the end of procedure, complicated dissection, necessity of stent implantation, acute re-occlusion, restenosis or reocclusion during recoronary angiography after 24 h, and infarction. Despite the advantage of rotablation with significant reduction of early and stabile dissections (p < 0.01) only slight difference in restenosis-rate and comparable results for the rest parameters were achieved.

Results of this study demonstrate no advantage in using rotablation after recanalization of chronic coronary occlusion in comparison to sequential PTCA.