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Intracoronary adenosine administered during rotational atherectomy of complex lesions in native coronary arteries reduces the incidence of no‐reflow phenomenon
Author(s) -
Hanna George P.,
Yhip Peter,
Fujise Ken,
Schroth George W.,
Rosales Oscar R.,
Anderson H. Ver,
Smalling Richard W.
Publication year - 1999
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/(sici)1522-726x(199911)48:3<275::aid-ccd8>3.0.co;2-m
Subject(s) - medicine , adenosine , no reflow phenomenon , cardiology , artery , lesion , atherectomy , myocardial infarction , incidence (geometry) , coronary arteries , complication , surgery , stent , percutaneous coronary intervention , restenosis , physics , optics
Rotational atherectomy (RA) of complex, calcified lesions has been associated with a high incidence of no reflow ranging from 6%–15% and concomitant myocardial necrosis with adverse prognostic implications. There are no uniform strategies for preventing this complication. The role of intracoronary adenosine for the prevention of this phenomenon during RA has not been fully evaluated. We studied the procedural outcome of 122 patients who underwent RA of complex native coronary artery lesions. Fifty‐two patients received no adenosine but a variety of other agents. Seventy patients received intracoronary adenosine boluses (24 to 48 μg prior to and after each RA run). There was no difference in the type of lesion studied, run time, or Burr to artery ratio (0.6–0.7) between the two groups. Six patients without adenosine experienced no reflow (11.6%), with resultant infarction in the target artery territory, while only 1 of 70 patients (1.4%, P − 0.023) in the adenosine group experienced no reflow. No untoward complications were observed during adenosine infusion. Intracoronary adenosine bolus administered during rotational atherectomy is easy, safe, and may significantly reduce the incidence of no reflow, which may improve the 30‐day outcome of this procedure. Cathet. Cardiovasc. Intervent. 48:275–278, 1999. © 1999 Wiley‐Liss, Inc.