The efficiency of cutting balloon angioplasty in the treatment of in-stent restenosis

Objective: Although stents reduce the restenosis rate, stent restenosis continues to be a major problem and the optimal treatment of stent restenosis is still controversial. In this study, we aimed to investigate the angiographic recurrent stent restenosis rate at 6-12 months after successful cutting balloon angioplasty (CBA) for the bare metal stent restenosis. Methods: Thirty patients (mean age: 57.9 +/- 11.6, 22 males) undergoing successful CBA for the treatment of in-stent restenosis at our hospital were prospectively included in this study. Control coronary angiography was performed at 6-12 months after CBA. Lesion length, minimal lumen diameter (MLD), and reference vessel diameter were analyzed by computerized digital angiographic analysis. Recurrent restenosis was defined as the lesions obstructing the lumen more than 50%. We described the lesions shorter than 10 mm as to be focal and those longer than 10 mm as to be diffuse. We used Student t, Chi-square, and Mann-Whitney U tests for statistical analysis. Results: Two patients had two distinct lesions; therefore, 32 lesions were assessed. There were 9 (28.1%) recurrent restenosis on the control coronary angiography. Recurrent restenosis developed in 3/21 (14.3%) of focal type lesions and 6/11(54.5%) of diffuse type lesions (p=0.035). Pre-procedural MLD was lower in the restenotic group compared to non-restenotic group (0.41 +/- 0.29 vs. 0.64 +/- 0.17 mm, p=0.048) while percent of stenosis was higher in the restenotic group (76.8 +/- 12 vs. 69.6 +/- 5.37%, p=0.029). Conclusion: In the selected patients, CBA is an effective and a safe method for the treatment of bare metal stent restenosis. CBA might be considered as a first-line treatment method in patients with focal type lesions. (Anadolu Kardiyol Derg 2011; 11: 436-40)