Current trends and procedural outcomes in the era of rotational atherectomy expansion in Poland in the period 2014–2017 (based on the nationwide ORPKI registry)

Introduction
The availability of rotational atherectomy (RA) has recently increased in Poland, which was followed by an increase in the rate of RA procedures and catheterization laboratories performing RA.

Aim
To assess current trends regarding the rapid increase in the number of RA procedures and catheterization laboratories performing RA.

Material and methods
We analyzed patients treated with percutaneous coronary intervention (PCI) in the years 2014–2017 available in the nationwide ORPKI dataset. From the overall 431,467 patients treated with PCI, we extracted 1,873 treated with RA. We analyzed the relationship between frequency of RA usage, its distribution between low and high volume centers and procedural outcomes, procedural-related complications and the PCI effectiveness expressed as the target vessel patency rate after PCI.

Results
The number of RA procedures increased from 181 in 2014 (0.19%) to 698 in 2017 (0.61%), with an over two-fold increase in the number of catheterization laboratories performing RA from 25 (15.5%) in 2014 to 55 (34.1%) in 2017. Besides the fact that patient characteristics have changed in the most recent years, the rate of procedural success expressed as procedure-related complications remained stable in the 3 years 2015–2017 and was around 3%, while the procedural effectiveness expressed as patent target coronary artery after PCI was stable and over 98% in all of the analyzed years.

Conclusions
Along with the increasing number of RA procedures and catheterization laboratories performing RA in Poland, the procedural effectiveness remained stable during an observational period of 4 years.