730-4 Vessel Size and the Outcome of DCA

Abstract

The purpose of this study is to evaluate the relationship between vessel size and outcome of directional coronary atherectomy (DCA). Patients who underwent DCA for lesions in native coronary arteries were included. Reference vessel size was quantitatively measured using a computer assisted system. Based on reference vessel size (VS), lesions were categorized in 5 groups: VS 2.0(<2.25 mm). VS 2.5 (2.25–2.75 mm), VS 3.0 (2.75–3.25 mm), VS 35 (3.25–3.75 mm) and VS 4.0 (≥3.75 mm). The outcome of DCA was as follows: VS 2.0 VS 25 VS 3.0 VS 35 VS4.0 p Lesions 242 357 303 187 146 Acute outcome VDR 0.96 1.20 1.39 1.58 1.88 < 0.009 DCA success 93% 92% 93% 91% 95% n.s. Perforation 0.4% 0.3% 0.3% 0% 0.7% n.s. CABG 1.2% 2.8% 3.0% 4.3% 1.4% n.s. Tissue (mg) 12.5 13.9 14.2 18.0 14.7 < 0.001 % residual 14% 14% 14% 19% 19% < 0.001 Restenosis (6 month) Primary 53% 47% 38% 24% 20% < 0.001 Restenosed 57% 49% 39% 34% 28% 0.03 VDR: Vessel device ratio In conclusion, the outcome of DCA was not significantly influenced by vessel size in selected cases. Despite a trend toward a higher residual stenosis, the restenosis rate was significantly lower in groups with a larger vessel size.