L. Cannon et al., Directional coronary atherectomy in intermediate sized vessels: Final results of the intermediate vessel atherectomy trial (IVAT), CATHET C IN, 49(4), 2000, pp. 396-400
Revascularization options for intermediate sized vessels (2.5-2.9 mm) have
historically been limited. IVAT is a pilot study to assess the efficacy and
safety of debulking intermediate sized vessels using directional coronary
atherectomy (DCA). Between March 1996 and June 1997, 50 patients were enrol
led at seven hospitals in the United States. Of those patients, 70% present
ed with unstable angina and 52% had single vessel disease. Of the lesions t
reated, 96% were de novo. Adjunctive PTCA after DCA was performed in 90% of
cases at the discretion of the investigator to maximize luminal diameter.
The GTO DCA device was used in 90% of cases. Procedural success (residual s
tenosis <50% without major complications) was 94%. Stents were placed in 12
% of patients. The only complications were three non-Q wave Mis. Mean refer
ence vessel diameter increased from 2.49 mm pre-procedure to 2.57 mm after
DCA and 2.61 post-procedure; mean MLD increased from 0.76 mm to 2.03 mm to
2.31 mm; and mean stenosis decreased from 70% to 21% post DCA and to 11% po
st procedure, At six months follow-up, 18.0% of target lesions required rev
ascularization. fetal revascularization, including non-target vessels, was
32%, These results suggest that DCA has a high procedural success rate and
a low target lesion revascularization rate in intermediate sized vessels. (
C) 2000 Wiley-Liss, Inc.