Safety and effectiveness of percutaneous coronary intervention using rotational atherectomy and new-generation drug-eluting stents for calcified coronary artery lesions in patients with chronic kidney disease

Malik, Fazila Tun Nesa; Kalimuddin, Md; Ahmed, Nazir; Badiuzzaman, Mohammad; Khan, Abdul Kayum; Dutta, Ashok; Huq, Tawfiq Shahriar; Banik, Dhiman; Ahmed, Mir Nesaruddin; Rahman, Md. Habibur; Iqbal, Md. Abu Tareq

doi:10.1016/j.ihj.2021.04.007

Cited by 1 publication

(2 citation statements)

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“…Again, ACS was presented in only 18% of their patients and they did not report procedural outcomes. Malik FTN et al studied the safety and efficacy of RA with new-generation DES in patients with CKD [ 15 ]. The procedural success was very high (97.5%), and procedural complications were low.…”

Section: Discussionmentioning

confidence: 99%

“…There were very limited studies investigating the impact of renal insufficiency on the outcomes of coronary RA in the literature [ 14 , 15 ], especially in very-high-risk patients. This retrospective study was set to evaluate the clinical features, procedural details, and immediate/intermediate results of RA in patients with advanced renal insufficiency through ESRD.…”

Section: Introductionmentioning

confidence: 99%

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Rotablation in Patients with Advanced Renal Insufficiency through End-Stage Renal Disease: Short- and Intermediate-Term Results

Chen

Lai

et al. 2022

Journal of Interventional Cardiology

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Objective. Patients with advanced renal insufficiency are at high risk of coronary artery disease (CAD) and complex lesions. Treating complex calcified lesion with rotational atherectomy (RA) in these patients might be associated with higher risks and poorer outcomes. This study was set to evaluate features and outcomes of RA in these patients. Method. Consecutive patients who received coronary RA from April 2010 to April 2018 were queried from the Cath Lab database. The procedural details, angiography, and clinical information were reviewed in detail. Results. A total of 411 patients were enrolled and divided into Group A (baseline serum creatinine <5 mg/dl, n = 338) and Group B (baseline serum creatinine ≥ 5 mg/dl through ESRD, n = 73). Most patients had high-risk features (65.7% of acute coronary syndrome (ACS), 14.1% of ischemic cardiomyopathy, and 5.1% of cardiogenic shock). Group B patients were significantly younger (66.8 ± 11.4 vs. 75.2 ± 10.7 years, p < 0.001 ) and had more RCA and LCX but less LAD treated with RA. No difference was found in lesion location, vessel tortuosity, bifurcation lesions, chronic total occlusion, total lesion length, or total lesion numbers between the two groups. Less patients in Group B obtained completion of RA (95.9% vs 99.1%, p = 0.037 ). There was no difference in the incidence of procedural complication or acute contrast-induced nephropathy. Group B patients had more deaths and MACE while in the hospital. The MACE and CV MACE were also higher in Group B patients at 180 days and one year, mostly due to TLR and TVR. Multivariate regression analysis showed that ACS, age, peripheral artery disease (PAD), advanced renal insufficiency, ischemic cardiomyopathy/shock, and high residual SYNTAX score were independent risk factors for in-hospital MACE, whereas ACS, advanced renal insufficiency, ischemic cardiomyopathy/shock, triple-vessel disease, and PAD independently predicted MACE at 6 months. Conclusions. Rotablation is feasible, safe, and could be carried out with very high success rate in very-high-risk patients with advanced renal dysfunction through ESRD without an increase in procedural complication.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%