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- Title
Reappraisal Value of a Modified Rotational Atherectomy Technique in Contemporary Coronary Angioplasty Era.
- Authors
Dong, Haojian; Hachinohe, Daisuke; Nie, Zhiqiang; Kashima, Yoshifumi; Luo, Jianfang; Haraguchi, Takuya; Shitan, Hidemasa; Watanabe, Tomohiko; Tadano, Yutaka; Kaneko, Umihiko; Sugie, Takuro; Kobayashi, Ken; Kanno, Daitaro; Enomoto, Morio; Sato, Katsuhiko; Fujita, Tsutomu
- Abstract
<bold>Objectives: </bold>To introduce a modified rotational atherectomy (RA) procedure and investigate the early and midterm outcomes of the RA-facilitating diversified percutaneous coronary intervention (PCI) in a large group of aged patients with higher cardiovascular risk.<bold>Background: </bold>Previous studies about the outcomes of RA were limited with small sample size and low-risk population.<bold>Methods: </bold>Between January 2013 and November 2015, 1169 consecutive patients treated with modified RA-facilitated PCI were retrospectively enrolled, including de novo calcified lesions and in-stent restenosis. Patients were regularly followed up for at least 1 year. Major adverse cardiac events (MACE) were analyzed for all participants by different strategies. Cox regression analysis was performed to identify risk factors for the events.<bold>Results: </bold>The median age of patients was 75 years, with 11.7% of patients on maintenance hemodialysis. Most lesions (99.9%) were complex (American Heart Association type B2/C), and 68.3% were treated with RA + drug-eluting-stent (DES). Successful angiography was achieved in 97.8% cases, with 1.7% (20/1169) experiencing coronary perforation (including guidewire perforation). The incidence of MACE was 20.5% and 26.8% at 1-year and 2-year follow-up and were mainly driven by target lesion revascularization (TLR) (10.3% and 12.5%, respectively). The strategy of RA + DES had the lowest 2-year MACE, compared with the RA + drug-coated balloon and RA + plain old balloon angioplasty (14.5%, 30.5%, and 26.0%, respectively).<bold>Conclusions: </bold>The modified RA technique is a safe and effective tool in the contemporary PCI era, even in high-risk patients. The TLR rate was relatively high but acceptable in such complex lesions.
- Subjects
AMERICAN Heart Association; ENDARTERECTOMY; TRANSLUMINAL angioplasty; PERCUTANEOUS coronary intervention; ANGIOPLASTY; OLDER patients
- Publication
Journal of Interventional Cardiology, 2020, p1
- ISSN
0896-4327
- Publication type
journal article
- DOI
10.1155/2020/9190702