Coronary rotational atherectomy in current practice: Acute and mid‐term results in high‐ and low‐volume centers

Abstract

We conducted a prospective observational study to evaluate the indications, technique, in-hospital and 9-month results of consecutive patients treated with rotational atherectomy (RA) in 12 centers during 1 year, as well as their relationship with volume of RA activity. The study included 345 lesions in 289 patients treated (4.4% +/- 2.6% of procedures at the participating centers). The lesions were mostly calcified (63%) and type B2 or C (74%). Procedural success was obtained in 94% of patients, with a major adverse cardiac event (MACE) rate of 4.5%. At 9 months, MACE occurred in 17.3%. Multivariate analysis identified multivessel disease and slow flow as negative predictors of procedural success, whereas balloon pressure <or= 6 atm and hypercholesterolemia were associated with decreased MACE at 9 months. Center RA volume was not associated with in-hospital or 9-month outcome. We conclude that RA, even when used sporadically in selected complex lesions, can provide good immediate and mid-term results.

Rotational Atherectomy for Left Main Coronary Artery Disease in Octogenarians: Transradial Approach in a Tertiary Center and Literature Review

“…When there was no LMCA disease among the treated lesions or when this information was missing in the article or when no systematic stenting was performed, the series was not considered. Table presents the details and the results of the most relevant trials where rotational atherectomy was used previous to stenting and where the LMCA was almost implicated among the whole lesions of each series. The procedural successes were ≥90% in all the series reaching sometimes 100%.…”

An evidence‐based approach to the use of rotational and directional coronary atherectomy in the era of drug‐eluting stents: When does it make sense?

“…From these results, DES have become the treatment of choice for native as well as in-stent restenotic lesions. RA now accounts for less than 5% of all interventional cases [41,42].…”

Reappraisal Value of a Modified Rotational Atherectomy Technique in Contemporary Coronary Angioplasty Era

“…However, the volume of RA was reported to vary widely in these two decades and between individual centers, ranging from 0.6%-20% [10,11]. In addition, the use of RA showed a trend of progressive decline due to the advent of the DES, the disappointingly high restenosis rate, and lack of impact on major adverse cardiac events (MACE) [12,13].…”