| Title | Comparison of intracoronary adenosine and isosorbide dinitrate on no-reflow/slow flow during rotational atherectomy. | | Author(s) | Tsao TP, Cheng SM, Cheng CC, Yang SP | | Institution | Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defence Medical Centre, Taiwan, Republic of China. | | Source | Acta Cardiol 2009 Apr; 64(2):225-30. | | MeSH | Adenosine
Aged
Atherectomy, Coronary
Coronary Angiography
Coronary Artery Disease
Coronary Circulation
Coronary Vessels
Drug Therapy, Combination
Female
Follow-Up Studies
Humans
Injections, Intra-Arterial
Isosorbide Dinitrate
Male
Monitoring, Intraoperative
Regional Blood Flow
Retrospective Studies
Treatment Outcome
Vasodilator Agents
| | Abstract | OBJECTIVE: To compare the effect of intracoronary adenosine and isosorbide dinitrate (ISDN) on no-reflow/slow flow during high-speed rotational atherectomy (HSRA) in patients with complex coronary artery disease (CAD).
METHODS AND RESULTS: Medical records from consecutive patients diagnosed with complex CAD between November 2002 and March 2006 who underwent HSRA at the Tri-Service General Hospital, National Defence Medical Centre in Taipei, Taiwan, were included in this study. Patients in the adenosine group (n=32) received a 50 microg intracoronary adenosine bolus prior to the initiation of burr rotation and during each ablation. Patients in the ISDN group (n=58) received a 0.5 mg intracoronary ISDN bolus at comparable time points. Angiographic success was achieved in 100% of patients in the adenosine group and 98.3% (57/58) in the ISDN group.The procedural success rates were 96.9% (31/32) in the adenosine group and 89.7% (52/58) in the ISDN group. One patient (3.1%) from the adenosine group and six patients (10.3%) from the ISDN group experienced no-reflow/slow flow (P = 0.414). No in-hospital mortality occurred and target vessel revascularization was unnecessary.
CONCLUSIONS: Intracoronary administration of either adenosine or ISDN during HSRA appears safe and administration of either agent may be effective in decreasing the incidence of no-reflow/slow flow during HSRA. Further large, prospective, randomized, placebo-controlled trials are required. | | Language | eng | | Pub Type(s) | Comparative Study
Journal Article
| | PubMed ID | 19476116 |
|
