High speed arteriosclerotic lesion ablation for treatment of coronary artery disease

摘要: Percutaneous high frequency coronary rotablation using the rotablator is able to remove arteriosclerotic material from vessel wall. A diamond-coated (15–30 µm) brass burr drill fastened a flexible drive shaft rotating and tracking along coaxial guide wire used. The turbine rotates at 150,000–180,000 rpm. High speed rotational angioplasty was successful in 27 of 28 patients. In about 40%, additional PTCA necessary due limited experience with deuce diameter initially. Only one patient went bypass surgery myocardial infarction (CK < 150 u/l) occurred only No perforation observed. All vessels were open 24 hours post-procedure. By cineventro-culography, echocardiography 201-Thallium-scintigraphy no signs peripheral embolism induced ischemia detected. Also, flow reserve not reduced, but increased, similar effect observed after PTCA. Side effects spasm 7/28 patients, bradycardia 5/28 AV block 1/28 patients possible related microbubbles. An important indication for seems be rigid sclerotic lesions, which cannot treated by conventional balloon catheter. Future studies will judge restenosis rate this method.