Coronary rotational atherectomy in patients with unsuccessful classical angioplasty – in-hospital and six-month follow-up

Background: The data regarding follow-up of high-risk patients after coronary rotational atherectomy (RA) are poor.

Aim: The aim of this study was to evaluate the in-hospital and 6-month outcome of patients with uncrossable or undilatable lesions who were treated with RA.

Material and methods: The RA was performed in 62 consecutive patients (mean EuroSCORE: 6.8 ±4) and all of them were enrolled. Major adverse cardiac events (MACE) were defined as all-cause death, cardiac death, stroke, myocardial infarction (MI), target lesion revascularization (TLR), and target vessel revascularization (TVR).

Results: The procedural success rate was 94%. The incidence of MACE was 9.7% in hospital (6 MIs, 3 of them with signs of ischemia) and 9.7% at 6-month follow-up (2 deaths, 3 MIs, 1 TLR). Death occurred in 2 patients (3%): due to definite stent thrombosis, and because of acute heart failure in a patient with low ejection fraction (EF).

Conclusions: In this very high risk population RA provides good outcomes with relatively low risk of MACE.