Cutting balloon angioplasty and stenting for aorto-ostial lesions.

Abstract

To investigate the use of a cutting balloon to overcome aorto-ostial lesions before stent implantation and thereby reduce the restenosis rate. Observational follow up study. Tertiary referral centre. 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). 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. Cutting balloon angioplasty followed by stent insertion is a feasible technique for the treatment of aorto-ostial lesions, meriting further investigation.