Complex coronary lesions and rotational atherectomy: one hospital’s experience

Jiang, Jun; Sun, Yong; Xiang, Meixiang; Liang, Dong; Liu, Xianbao; Hu, Xinyang; Yuan, Feng; Wang, Jianan

doi:10.1631/jzus.b1201008

Cited by 10 publications

(4 citation statements)

References 16 publications

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“…As a result, the total combined MACE rate over a long follow up period is anticipated to be high. Most of the published studies have shown a MACE rate ranging between 11.3 and 20.7%, with the exception of the ROTAXUS study which showed a 24.2% MACE rate in patients with RA and DES implantation . Our multicentre data represent one of the largest observational studies with one of the longest follow up periods, and show a 17.8% MACE rate which is comparable to other studies with smaller sample size and shorter follow up.…”

Section: Discussionsupporting

confidence: 71%

Cardiovascular Outcomes Following Rotational Atherectomy: A UK Multicentre Experience

Eftychiou

Barmby

Wilson

et al. 2016

Cathet Cardio Intervent

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Section: Discussionsupporting

confidence: 71%

Cardiovascular Outcomes Following Rotational Atherectomy: A UK Multicentre Experience

Eftychiou

Barmby

Wilson

et al. 2016

Cathet Cardio Intervent

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“…The main acute adverse outcomes were dissections and perforations, while MI and restenosis predominated in the late stages. 9 Encouraging results were presented in PREPARE-CALC, in which 200 patients were randomized to treatment with either RA or modified balloons. A higher success rate was achieved with RA (98% versus 81%, respectively), mainly driven by balloon crossing failure, with no significant difference in late luminal loss at 9 months.…”

Section: Discussionmentioning

confidence: 99%

Morbidity and mortality in a cohort of individuals undergoing rotational atherectomy for extremely calcified lesions

Amaral¹,

Rocha²,

Prudente³

et al. 2021

J Transcat Intervent

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Background: The treatment of coronary arteries with heavily calcified or chronically occluded lesions has the lowest success rates when they undergo a percutaneous procedure. A strategy to reduce the volume of calcified lesions, which was part of the rescue technique to treat non-balloon dilatable stenoses, has evolved to an approach of primary lesion preparation for subsequent stenting. Methods: This is a retrospective analysis of data related to rotational atherectomies performed in complex, high-risk patients, for treating extremely calcified lesions with drug-eluting stent implantation, obtained from the Tasy Electronic Medical Record, between 2012 and 2016. Results: A cohort of 138 individuals was followed up after rotational atherectomy between 2012 and 2016. The most frequently observed risk factors were hypertension (87%), dyslipidemia (69%), diabetes mellitus (44%), and sedentary lifestyle (72%). A total of 244 vessels were treated, 179 of which with the aid of rotational atherectomy, and 308 drug-eluting stents were implanted. The SYNTAX II score was 22.4±11.5, with 18% of individuals classified as high risk (>33 points); femoral arterial access was employed in 76.8%. Lesion transposition was achieved in 98% of cases. Angiographic success was achieved with stenting in 98% of procedures. The length of hospital stay was 2.6±3.7 days. In-hospital mortality was 4%, and 4-year mortality was 14.5%. Long-term follow-up was performed by phone calls up to 4 years after the procedure. Ninety-seven percent of patients maintained regular use of dual antiplatelet therapy. Only 42% reported regular exercise. Angina pectoris was reported by 13% of individuals. Conclusion: Rotational atherectomy showed a low occurrence of adverse events in the immediate and late phases, leading to a high success rate of stent implantation in complex lesions.

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“…28 The choice of burr size depending on burr/artery ratio of 0.5 to 0.7 mm has been evaluated in many studies. 29,30 It was associated with both short-and long-term favorable outcomes. We reported a low incidence of complications (both dissection and perforation occurred in 6.3% of the patients) and a high rate of angiographic success (overall percentage in both groups is 92.3%), as we avoided oversizing of the burr and used a maximum of 2 burrs/lesion.…”

Section: Discussionmentioning

confidence: 99%

Very Long-Term Follow-Up After Coronary Rotational Atherectomy: A Single-Center Experience

et al. 2016

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We assessed the very long-term follow-up of a large cohort of unselected patients treated with coronary rotational atherectomy (RA). All 143 patients who underwent RA at our institution from 2000 to 2013 and with complete baseline and follow-up information were analyzed in a retrospective manner. Major adverse cardiac events (MACE) were defined as the composite of target vessel revascularization (TVR), acute myocardial infarction, and all-cause mortality. The mean follow-up was 8.2 years. The 10-year cumulative incidence of MACE for all patients was 57.9% (standard error [SE]: 5.0%). When comparing patients who received a drug-eluting stent (DES; n = 68) versus patients who did not (balloon only, bare-metal stent, or none of the aforementioned; n = 75), the RA + DES demonstrated very long-term MACE of 49.2% (SE: 7.5%) versus 62.7% (SE: 6.1%), P = .160 with TVR as the most discriminating factor, 10.7% (SE: 4.0%) versus 29.2% (SE: 6.0%), P = .016. Our results point to RA having reasonable long-term clinical results, especially in combined treatment with DES. To date, our study has the longest follow-up after RA.

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Complex coronary lesions and rotational atherectomy: one hospital’s experience

Cited by 10 publications

References 16 publications

Cardiovascular Outcomes Following Rotational Atherectomy: A UK Multicentre Experience

Cardiovascular Outcomes Following Rotational Atherectomy: A UK Multicentre Experience

Morbidity and mortality in a cohort of individuals undergoing rotational atherectomy for extremely calcified lesions

Very Long-Term Follow-Up After Coronary Rotational Atherectomy: A Single-Center Experience

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