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Rotational atherectomy or balloon angioplasty in the treatment of intra-stent restenosis: BARASTER Multicenter Registry

2000; Wiley; Volume: 51; Issue: 4 Linguagem: Inglês

10.1002/1522-726x(200012)51

1522-726X

Steven L. Goldberg, Peter B. Berger, David J. Cohen, Fayaz A. Shawl, Maurice Buchbinder, Richard Fortuna, William O’Neill, Martin B. Leon, Gregory A. Braden, Paul S. Teirstein, Mark Reisman, Steven R. Bailey, Harold L. Dauerman, Terry R. Bowers, Roxanna Mehran, Antonio Colombo,

Acute Myocardial Infarction Research

The BARASTER registry was formed to evaluate the initial success and long-term results of rotational atherectomy in the management of in-stent restenosis. Rotational atherectomy was used in 197 cases of in-stent restenosis: 46 with stand-alone rotational atherectomy or at most 1 atmosphere of balloon inflation (Rota strategy), and 151 with rotational atherectomy and adjunctive balloon angioplasty <1 atmosphere (Combination strategy). These were compared with 107 episodes of in-stent restenosis treated with balloon angioplasty alone. In this observational study, the use of Combination therapy was associated with a slightly higher initial success rate (95% vs. 87% with the Rota strategy and 89% with Balloons, P = 0.08). There was a reduction in one year clinical outcomes (death, myocardial infarction or target lesion revascularization) in the combination group (38% vs. 60% with Rota and 52% with balloons, P = 0.02). These data support a benefit of the strategy of debulking with rotational atherectomy followed by adjunctive balloon angioplasty, in the management of in-stent restenosis. Cathet. Cardiovasc. Intervent. 51:407–413, 2000. © 2000 Wiley-Liss, Inc.