eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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SCImago Journal & Country Rank
2/2018
vol. 14
 
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abstract:
Original paper

Comparison of outcomes in patients undergoing rotational atherectomy after unsuccessful coronary angioplasty versus elective rotational atherectomy

Jaroslaw Gorol
,
Mateusz Tajstra
,
Bartosz Hudzik
,
Andrzej Lekston
,
Mariusz Gąsior

Adv Interv Cardiol 2018; 14, 2 (52): 128–134
Online publish date: 2018/06/19
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Introduction
Revascularization of patients with heavily calcified coronary arteries can be a challenge for interventional cardiologists. The procedural success rate in these patients can be improved by using rotational atherectomy (RA).

Aim
To compare in-hospital outcomes and those at 12-month follow-up between patients who underwent RA as a bailout procedure secondary to failed conventional angioplasty or as an elective procedure.

Material and methods
This is a retrospective analysis of 156 consecutive patients hospitalized at a high-volume percutaneous coronary intervention (PCI) center who underwent RA. In 43 (27.6%) patients, RA was performed on an elective basis (group 1). In 113 (72.4%) patients RA was carried out after unsuccessful traditional angioplasty (group 2).

Results
Patients in group 1 more often had a history of peripheral vascular disease (32.6% vs. 15.9%; p = 0.03). Group 1 was dominated by patients with multivessel disease (62.8% vs. 33.6%; p < 0.001). The left main coronary artery was more often treated in group 1 (25.6% vs. 2.7%; p < 0.001). Success rates in the two groups were similar: 93.0% for group 1 and 91.2% for group 2 (p = 0.71). The rate of in-hospital complications did not significantly differ between the groups. Twelve-month MI, TLR, and TVR rates were similar in both groups. There was no difference in the 12-month survival rate (86.1% vs. 92.0% in group 2; p = 0.27) or MACE (16.3% vs. 15.0%; p = 0.8).

Conclusions
Rotational atherectomy is associated with high efficacy and a relatively low risk of complications, with no significant differences in outcomes between patients treated with primary and secondary RA procedures.

keywords:

coronary artery disease, rotablation, calcifications

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