Usefulness of rotablator in the treatment of coronary artery disease in hemodialysis patients

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  • 透析患者の冠動脈病変に対するロータブレータの有用性

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Abstract

Patients receiving hemodialysis (HD) often have severely calcified and diffuse stenosis in the coronary arteries. Recently, rotablator, which is a new device for percutaneous transluminal coronary angioplasty (PTCA), has been widely used for coronary artery disease. In this study, we evaluated the usefulness of rotablator in the treatment of coronary artery disease in HD patients. We analyzed early and late outcome of 78 hemodialysis patients (HD group) and 319 non-hemodialysis patients (non-HD group) with coronary artery disease who were treated with rotablator in our hospital between March 1997 and September 1999. There was no significant difference between the two groups in age, gender distribution, past history of diabetes mellitus, hyperlipidemia or myocardial infarction. The prevalence of hypertension among patients with HD was greater than that among non-HD patients. Otherwise, the patients in the non-HD group had more left anterior descending (LAD) lesions than those in the HD group. The initial success rate of this procedure was 94.7% in the HD group and 94.6% in the non-HD group. Regarding the results 6 months after the rotablator procedure, the rate of restenosis was 51.4% and 47.0% in the HD group and non-HD group, respectively. There was no significant difference between the two groups in the rate of cardiac accidents, a newly developed acute myocardial infarction and target lesion revascularization (45.3% vs. 44.9%). In conclusion, we demonstrated that rotablator is a useful tool for the treatment of coronary artery disease in patients with HD.

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