Percutaneous transcatheter therapy of aorto-ostial stenoses

The treatment of native coronary and saphenous vein graft aorto-ostial stenoses with balloon angioplasty (PTCA) has been associated with lower procedural success rates, more frequent in-hospital complications and a greater likelihood of late restenosis when compared with PTCA of non-ostial stenoses. The advent of ablative technologies and intracoronary stents have significantly altered both early and late outcomes of percutaneous intervention for aorto-ostial disease. The optimal approach to this complex lesion subset often involves decalcification or tissue ablation followed by stent deployment. Improvements in currently available stent technology including enhanced radial force and visibility, reduced thrombogenicity, and the availability of shorter stent lengths, may also facilitate stent deployment and further improve outcomes following percutaneous transcatheter therapy for aorto-ostial stenoses.