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Cutting balloon angioplasty and stenting for aorto-ostial lesions
A S Kurbaan1, P A Kelly, U Sigwart
1Department of Invasive Cardiology, Royal Brompton Hospital/National Heart and Lung Institute, London, United Kingdom.
Objective:
To investigate the use of a cutting balloon to overcome aorto-ostial lesions before stent implantation and thereby reduce the restenosis rate.
Design:
Observational follow up study.
Setting:
Tertiary referral centre.
Patients:
Eight patients (two female, six male) aged 58.2 (SD 10.1) years with Canadian Cardiovascular Society (CCS) grade II-IV angina were recruited. They each had a single target lesion (three in native coronaries, five in vein grafts).
Intervention And Results:
After high pressure angioplasty (18 (3.8) bar), there was only a small reduction in the luminal stenosis, from 82 (9)% to 68 (10)%, as assessed by on line quantitative coronary angiography. However, using the cutting balloon there was a marked reduction in the luminal stenosis to 44 (15)%, facilitating stent insertion. Subsequent high pressure dilatation resulted in a final stenosis of 10 (7)%. At 6 (2) months' follow up the marked symptomatic improvement, to CCS angina grade 0-II, was maintained and there were no further cardiac events or interventions.
Conclusion:
Cutting balloon angioplasty followed by stent insertion is a feasible technique for the treatment of aorto-ostial lesions, meriting further investigation.