Rotablation in complex ACS versus Non-ACS patients: Prospective follow up study from tertiary care centre in North India

Ary, Kunwer Abhishek; Gupta, Himanshu; Barward, Parag; Bahl, Ajay; Sharma, Yash Pal

doi:10.1016/j.ihj.2022.11.008

Cited by 1 publication

(1 citation statement)

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“…18,20 The safety and potential necessity of RA in ACS patients has been previously published. 27 Angiographically, LM followed by LAD and LCX were the most common vessels involved. The mean SYNTAX score was 34.9 ± 7.7, higher than the mean SYNTAX score of other similar trials, including the ROTATE registry, and studies by Sulimov et al and Dahdouh et al, where the mean SYNTAX scores were 30, 28 and 29, respectively.…”

Section: Discussionmentioning

confidence: 96%

Left Main Rotablation: Case Series From a Tertiary Care Centre in North India

Gupta,

Verma,

Sharma

et al. 2023

J Asian Pac Soc Cardiol

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Background: Calcified left main (LM) disease is an important subset of coronary artery disease, associated with a high risk and procedural complexity. Advances in percutaneous coronary intervention (PCI) are making it a viable alternative to coronary artery bypass grafting. Methods: This was a retrospective study of patients aged ≥18 years who underwent rotational atherectomy (RA)-assisted PCI of LM disease at a tertiary-care centre in North India from August 2018 to May 2023. PCIs also involved use of intravascular ultrasound and adjuvant plaque-modifying therapies, such as cutting balloons, and intravascular lithotripsy, as indicated. Procedural details and clinical outcomes were analysed. Results: The study included 55 consecutive patients. A total of 52 patients (94.5%) were men, and the mean age was 64.7 ± 9.0 years. The mean follow-up was 16.3 ± 11.2 months. The mean ejection fraction was 52.7 ± 8.2%. On angiography, the mean SYNTAX score was 34.9 ± 7.7, and true bifurcation lesions (Medina class 1,1,1 or 1,1,0) were present in 22 patients (40%). Adjuvant plaque modification therapy included a cutting balloon in 25 patients (45.5%), and intravascular lithotripsy in nine (16.4%). Intravascular ultrasound guidance was used in 46 patients (83.6%). Supported PCI was performed in six cases (10.9%). Angiographic success was achieved in 100% of the patients. One patient (1.8%) died in hospital due to an upper gastrointestinal bleed. On follow-up, one patient died (1.8%), and target vessel revascularisation was needed for three patients (5.5%). Conclusion: Rotational atherectomy-assisted PCI for calcific LM disease can be performed safely, with judicious use of intravascular ultrasound and adjunct plaque modification therapies, providing satisfying short- to medium-term outcomes.

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Section: Discussionmentioning

confidence: 96%