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).