21世紀の冠動脈インターベンション

Coronary intervention has come to achieve good results with the use of new devices,
such as Rotablator (ROTA), new directional coronary atherectomy (DCA), and a special
guide wire, even for lesions in which good results were not obtained with plain old balloon
angioplasty. In the present study, we evaluated the initial results in patients who underwent
ROTA procedures, coronary intervention for chronic total occlusion (CTO), and new
DCA procedures in our hospital between January and December 2001. (1) There were 99
patients who underwent ROTA, with an average age of 68±12 years, a lesion length of
15.9±9.9 mm, a reference vessel diameter of 2.7±0.6 mm, and a success rate of 98%.
Among these 99 patients, there were 82 patients (83%) with B2 or C type lesion, which is
difficult to treat. (2) There were 61 patients with CTO who underwent coronary intervention,
with an average age of 63±9 years, an occlusion length of 22.8±13.3 mm, a reference
vessel diameter of 2.6±0.7 mm, and a success rate of 82%. (3) There were 5 patients who
underwent DCA for ostial lesion of left anterior desending artery and the target lesion was
successfully dilated in all these patients.
These results indicated that new devices for coronary intervention have made it possible
to treat a wider range of lesions, but restenosis still remains to be solved. In Europe
and the U.S.A., restenosis is reported to have been drastically reduced by drug eluting stents,
which are expected to be introduced in Japan in the future.