Long‐term outcomes of rotational atherectomy for the percutaneous treatment of chronic total occlusions

Azzalini, Lorenzo; Dautov, Rustem; Ojeda, Soledad; Serra, Antonio; Benincasa, Susanna; Bellini, Barbara; Giannini, Francesco; Chavarría, Jorge; Gheorghe, Livia; Pan, Manuel; Carlino, Mauro; Colombo, Antonio; Rinfret, Stéphane

doi:10.1002/ccd.26829

Cited by 43 publications

(39 citation statements)

References 17 publications

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“…In the present study, the technical and procedural success rates were >95% in both groups, which was in accordance with the rates reported in previous studies of RA in CTO-PCI. 11,22 In this work, we found that the number of RAs was much lower with retrograde PCI than with the anterograde approach, which was not beyond our expectation. The retrograde approach itself is also considered to be an effective alternative method for cases of “balloon uncrossable” CTO lesions.…”

Section: Discussionmentioning

confidence: 44%

“…The retrograde approach itself is also considered to be an effective alternative method for cases of "balloon uncrossable" CTO lesions. [20][21][22][23] For example, in the retrograde approach, the reverse CART technique can be applied to avoid the hard plaques of the CTO segment through subintimal tracking. Moreover, after achieving complete wire externalization with a retrograde guidewire crossing through the CTO segment, strong backup support is provided by the bilateral guide catheter anchor for equipment delivery.…”

Section: Discussionmentioning

confidence: 99%

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Procedural and In-hospital Outcomes of Rotational Atherectomy in Retrograde Coronary Chronic Total Occlusion Intervention

Song

Chang

et al. 2020

Angiology

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Coronary chronic total occlusions (CTOs) are characterized by a high incidence of severe plaque calcifications, which are associated with a high use of the retrograde approach and a low success rate of percutaneous coronary intervention (PCI). However, the feasibility of rotational atherectomy (RA) in retrograde CTO-PCI remains unknown. The aim of the present study is to examine the safety and efficacy of RA in retrograde CTO-PCI. Consecutive patients (n = 129) who underwent RA during CTO-PCI were categorized into anterograde and retrograde groups according to the CTO crossing approach. The distributions of the baseline characteristics were similar in the 2 groups, but the lesion type was more complex ( P = .001), and the starting burr size was smaller ( P = .003) in the retrograde group than in the anterograde group. There was a trend of a higher incidence of procedural complications in the retrograde group than in the anterograde group ( P = .054). Technical and procedural success and in-hospital outcomes were not significantly different between the 2 groups. In conclusion, RA was feasible in retrograde CTO PCI, but some specific precautions are required before and during the procedure. In addition, further investigation of the long-term outcomes of RA in retrograde CTO PCI is necessary.

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Section: Discussionmentioning

confidence: 44%

Section: Discussionmentioning

confidence: 99%

Procedural and In-hospital Outcomes of Rotational Atherectomy in Retrograde Coronary Chronic Total Occlusion Intervention

Song

Chang

et al. 2020

Angiology

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“…However, slow‐flow/no‐reflow was noted in 17% of cases. Furthermore, their RA procedural success rate was significantly lower compared with the conventional PCI group (77% vs 88%, P = 0.04), while the long‐term MACE rate was similar between the RA and conventional group (15% vs 13%, P = 0.70) . Our results showed high success rate (96.2%) with low peri‐procedural complications (1 case), suggesting that RA might be a safe and effective technique for resistant CTO lesions.…”

Section: Discussionmentioning

confidence: 57%

Short‐term and long‐term clinical outcomes of rotational atherectomy in resistant chronic total occlusion

Huang

Teng

Chan

et al. 2018

J Interven Cardiology

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“…In extreme cases, such as in balloon failure‐to‐cross, antegrade RA might be decisive. Few studies have specifically analyzed the outcomes of this technique in CTO patients , while most of available data on RA concern its use in non‐occlusive coronary artery disease .…”

Section: Discussionmentioning

confidence: 99%

Rotational atherectomy in the subadventitial space to allow safe and successful chronic total occlusion recanalization: Pushing the limit further

Capretti

Carlino

Colombo

et al. 2017

Cathet Cardio Intervent

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Dissection and re-entry (DR) techniques have played a key role in the increase of success rates of chronic total occlusion (CTO) recanalization. DR usually allows wiring complex occlusions, even in case of important calcification. In extreme cases, such as in balloon failure-to-cross, rotational atherectomy (RA) might be decisive. However, according to experts' recommendations, RA should not be performed in dissection planes because of the high risk of perforation and further extending the dissection, so that its use after DR might be limited. Here, we describe a case of successful right coronary artery CTO recanalization in which, after failure of several antegrade and retrograde techniques, RA was safely performed antegradely in the subadventitial space, thus eventually enabling reverse controlled antegrade and retrograde subintimal tracking (CART). Although the feasibility of RA in CTO percutaneous coronary intervention had already been suggested, this case reports on the novel use of RA to allow further manipulation of the subadventitial space (reverse CART) prior to successful recanalization. V C 2017 Wiley Periodicals, Inc.

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Long‐term outcomes of rotational atherectomy for the percutaneous treatment of chronic total occlusions

Cited by 43 publications

References 17 publications

Procedural and In-hospital Outcomes of Rotational Atherectomy in Retrograde Coronary Chronic Total Occlusion Intervention

Procedural and In-hospital Outcomes of Rotational Atherectomy in Retrograde Coronary Chronic Total Occlusion Intervention

Short‐term and long‐term clinical outcomes of rotational atherectomy in resistant chronic total occlusion

Rotational atherectomy in the subadventitial space to allow safe and successful chronic total occlusion recanalization: Pushing the limit further

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