The safety and efficacy of a novel coronary atherectomy device were evaluated in the
first 50 patients who underwent 53 such procedures at the Mayo Clinic. This treatment
was used for atheromatous lesions in 27 patients and for restenosis after percutaneous
transluminal coronary angioplasty in 23; in 3 patients, it was repeated for recurrent
stenosis (2) or a persistent intimal flap (1). Successful results, defined as a reduction
of the stenosis by 40% or more in association with removal of tissue, absence of Q-wave
infarction, and no need for a bypass surgical procedure during in-hospital follow-up,
were achieved in 47 of the 53 procedures (89%). Atherectomy reduced the stenoses from
a mean of 87% to 15%. Failures occurred in 6 of the 53 procedures (11%). Three of
these patients subsequently underwent successful conventional balloon angioplasty,
and three required surgical treatment. Six patients had minor complications—embolization
of atheromatous material in two, intimal dissection in two, and side-branch occlusion
and transient thrombosis in one each. Coronary atherectomy with use of this device
promises to be a relatively safe and efficient treatment of coronary artery stenosis.
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© 1989 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.