Document Detail


Rotational atherectomy for fibro-calcific coronary artery disease in drug eluting stent era: procedural outcomes and angiographic follow-up results.
MedLine Citation:
PMID:  20432398     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to examine the binary re-stenosis rates, procedural success, and in hospital outcomes following treatment of fibro-calcified coronary lesion with rotational atherectomy in drug eluting stent era.
BACKGROUND: Binary restenosis rates have remained high with the use of bare metal stents following rotational atherectomy in calcified lesions. There is limited data available following rotational atherectomy in drug eluting stent era.
METHODS: We evaluated the procedural and angiographic outcomes following a consecutive series of 516 procedures treated with rotational atherectomy followed by stenting. We compared the results between Rota + Drug eluting stent (DES) and Rota + bare metal stent (BMS) groups.
RESULTS: Procedural success was achieved in 97.1% of the lesions with overall low in hospital adverse events (death in 1.1%, Q MI in 1.3%, Non Q MI in 5.3%, and urgent repeat PCI in 0.4%). There was significant reduction in the binary restenosis rates following Rota + DES use as compared to Rota + BMS use (11% vs. 28.1%, P < 0.001; OR = 3.17, 95% CI: 1.76-5.93) and similar reduction was seen in the target lesion revascularization (10.6% vs. 25%, P = 0.001; OR = 2.81, 95% CI: 1.53-5.14). We have identified ostial lesions, chronic total occlusion lesions, and use of bare metal stents as independent predictors of restenosis in this group of patients.
CONCLUSIONS: Rotational atherectomy can be performed with high success rates and low complications, and rotational atherectomy followed by drug eluting stent implantation significantly reduces binary restenosis rates in fibrocalcific lesions as compared to rotational atherectomy and bare metal stents.
Authors:
Sudhir Rathore; Hitoshi Matsuo; Mitsuyasu Terashima; Yoshihisa Kinoshita; Masashi Kimura; Etsuo Tsuchikane; Kenya Nasu; Mariko Ehara; Yasushi Asakura; Osamu Katoh; Takahiko Suzuki
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  75     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-30     Completed Date:  2010-07-29     Revised Date:  2011-01-10    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  919-27     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Wiley-Liss, Inc.
Affiliation:
Department of Cardiology, Toyohashi Heart Center, Oyama-cho, Toyohashi, Japan. sudhirrathore@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Atherectomy, Coronary*
Calcinosis / surgery*
Cardiomyopathies / surgery*
Coronary Angiography
Coronary Restenosis / epidemiology
Drug-Eluting Stents
Female
Humans
Male
Middle Aged
Retrospective Studies
Risk Factors
Stents
Ultrasonography, Interventional
Comments/Corrections
Comment In:
Catheter Cardiovasc Interv. 2011 Jan 1;77(1):160; author reply 161   [PMID:  21069801 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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