Beneficial effect of rotational atherectomy with low platform speed on late outcomes

Background: Modification of rotational atherectomy (RA) procedures might be expected to alter restenosis rates. Methods and results: From June 1998 (period 2), platform speed was decreased to 150,000-160,000 rpm from the 170,000-190,000 rpm performed from August 1997 to May 1998 (period 1). Patients for the two periods (period 1: 62 patients, 70 lesions; period 2: 85 patients, 91 lesions) demonstrated comparable clinical and angiographic baseline data, allowing immediate and late outcomes to be evaluated for comparison. Restenosis rates in periods 1 and 2 were 57.9% and 33.8%, respectively (P = 0.01). Platform speed and lesion length were independent predictors of restenosis by multivariate logistic regression analysis. Conclusions: RA with a low platform speed (150,000-160,000 rpm) can be performed with a high success rate and with a lower incidence of restenosis than with a high platform speed (170,000-190, 000 rpm).