Quantitative Analysis of Factors Influencing Late Lumen Loss and Restenosis After Directional Coronary Atherectomy

Although encouraging initial results have been demonstrated after directional atherectomy, the mechanisms and predictors of late lumen loss and restenesis after this precedure have not been evaluated. To examine these issues, clinical and angiographic followup were obtained in 262 (96%) and 212 (77%) of 274 patients undergoing successful directional coronary atherectomy. Symptom recurrence developed in 67 (33%) patients and angrographic restenosis was found in 93 (44%). Restenosis was highest in restenotic lesions in saphenous vein grafts (76 % [95 % confi-dence interval (Cl): 56 to 100X]) and lowest in new-nset lesions in the left anterior descending (27 % [95 % Cl: 15 to 39%]) and circumflex (14