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Cutting Balloon Angioplasty With Stent Implantation Treats Aorto-Ostial Lesions Effectively

A report showed that combined cutting balloon angioplasty with bare metal stent (BMS) implantation is safe and effective for treating aorto-ostial coronary disease.

The cutting balloon demonstrated excellent clinical results for aorto-ostial lesions and may be an appropriate alternative solution for this problem, told Dr. Israel Gotsman from Hadassah University Hospital, Jerusalem, Israel.

Dr. Gotsman and colleagues investigated 48 patients with 1-year follow-up and reported their experience with cutting balloon angioplasty and BMS implantation for aorto-ostial lesions.

They reported that the procedure was successful in all patients, with an in-hospital major adverse coronary event (MACE) rate of 2.1%. The MACE rate was 0% among the 31 patients who had cutting balloon angioplasty without low-pressure predilatation.

During a mean 11.6 months of follow-up, 7 patients (16%) experienced anginal pain, and 12 were hospitalized due to unstable angina.

Seven of 12 patients who underwent repeat coronary angiography because of symptoms and noninvasive test results were found to have restenosis, the researchers note, and 4 of these underwent repeat balloon angioplasty (2 with stent implantation).

This represents an overall MACE rate of 13.6%, the investigators say.

In the subgroup of 31 patients who underwent cutting balloon angioplasty and BMS implantation without low-pressure balloon pre-dilatation, 2 (6%) had anginal pain, 9 were hospitalized due to unstable angina, and 5 (16%) developed restenosis during follow-up.

The MACE rate in this subgroup was 16%.

The results of our study suggest that this technique is safe and has an excellent clinical outcome, Dr. Gotsman said. The outcome was favorable and comparable to drug-eluting stent (DES) implantation. Therefore, this technique should be compared to the implantation of drug-eluting stents in a controlled study.

Dr. Gotsman added, Technically, the implantation of a cutting balloon is not significantly different from implantation of other available balloons and does not require any specific expertise.