Aterectomía rotacional (rotablator) en la angioplastía coronaria percutánea transluminal / Rotational atherectomy (rotablator) for percutaneous transluminal coronary angioplasty

RESUMEN

Background: The use of Rotablator in percutaneous transluminal coronary angioplasty attempts to reduce the atheromatous plaque abrading it and fragmenting the pariental calcium of the artery. Aim: To report our experience with the use of Rotablator: Patients and methods: Rotational atherectomy was performed in 189 patients aged 60.8 ñ 11 years (154 men). The clinical indication for the procedure was chronic angina in 22 percent, unstable angina in 44 por ciento, myocardial infarction in 21 percent, silent angina in 7 percent and re-stenosis in 6 percent. One bundred seventy seven patiens were followed for a mean of 15.9 ñ 6.3 months. Results: Two hundred thirty six stenoses in 215 coronary arteries were treated with a 98.7 percent angiographic success rate. One patient had a Q infarction and no patient died or required emergency surgery. Fourteen patients had rises in CK MB enzymes (non Q infarction). Thee patients had a pseudoaneurism and three had bleedings that required transfusion. Of the followed patients, 33 had a clinically suspected re-stenosis, that was angiographically confirmed in 23. Cardiac mortality was 2.3 percent. Seventy nine percent of patients had an evolution without angina or coronary events. Conclusions: Percutaneous transluminal coronary angioplasty with the use of Rotablator had a high immediate success rate and a low incidence of complications. The clinical evolution of patients has been favorable with a low incidence of mortality and ischemic events