Rotational atherectomy does not reduce recurrent in-stent restenosis: results of the angioplasty versus rotational atherectomy for treatment of diffuse in-stent restenosis trial (ARTIST)

Publication

Rotational atherectomy does not reduce recurrent in-stent restenosis: results of the angioplasty versus rotational atherectomy for treatment of diffuse in-stent restenosis trial (ARTIST)

Journal Paper/Review - Feb 5, 2002

vom Dahl Juergen, Reineke Thorsten, Hoffmann Rainer, Hamm Christian W, Garcia Eulogio, Ramsdale David R, Commeau Philippe, Thomas Martyn, Schiele François, Buettner Hans Juergen, Niccoli Luigi, Silber Sigmund, Haager Philipp K., Dietz Ulrich, Klues Heinrich G

Units

Kardiologie

PubMed

11827923

Citation

vom Dahl J, Reineke T, Hoffmann R, Hamm C, Garcia E, Ramsdale D, Commeau P, Thomas M, Schiele F, Buettner H, Niccoli L, Silber S, Haager P, Dietz U, Klues H. Rotational atherectomy does not reduce recurrent in-stent restenosis: results of the angioplasty versus rotational atherectomy for treatment of diffuse in-stent restenosis trial (ARTIST). Circulation 2002; 105:583-8.

Type

Journal Paper/Review (English)

Journal

Circulation 2002; 105

Publication Date

Feb 5, 2002

Issn Electronic

1524-4539

Pages

583-8

Brief description/objective

BACKGROUND: Aim of this trial was to compare rotational atherectomy followed by balloon angioplasty (rotablation [ROTA] group) with balloon angioplasty (percutaneous transluminal coronary angioplasty [PTCA] group) alone in patients with diffuse in-stent restenosis. METHODS AND RESULTS: The ARTIST study is a multicenter, randomized, prospective European trial with 298 patients with in-stent restenosis>70% (mean lesion length, 14 +/- 8 mm) in stents, implanted in coronary arteries for >/= 3 months. In the PTCA group, angioplasty was performed at the discretion of the local investigator, and rotablation was performed by using a stepped-burr approach followed by adjunctive PTCA with low (/= 50%) rates of 51% (PTCA) and 65% (ROTA) (P=0.039). By intravascular ultrasound, the major difference was the missing stent over-expansion during PTCA after ROTA. Six-month event-free survival was significantly higher after PTCA (91.3%) compared with ROTA (79.6%, P=0.0052). CONCLUSIONS: In terms of the primary objective of the study, PTCA produced a significantly better long-term outcome than ROTA followed by adjunctive low-pressure PTCA.