Acute Angulation and Sequential Lesion Increase the Risk of Rotational Atherectomy Failure
Open Access
- 25 May 2021
- journal article
- research article
- Published by Japanese Circulation Society in Circulation Journal
- Vol. 85 (6), 867-876
- https://doi.org/10.1253/circj.cj-20-1222
Abstract
Background:The aim of the study was to assess anatomical and procedural predictors of clinical and procedural failure of rotational atherectomy (RA) in an all-comers population. Methods and Results:A total of 534 consecutive patients who underwent RA were included in a double-center observational study. The primary composite endpoint consisted of: rota-wire introduction failure, burr-passage failure, periprocedural complications and procedure-related major adverse events. The second primary endpoint included rota-wire introduction failure and burr-passage failure. The primary endpoint occurred in 76 (14.2%) patients and the second primary endpoint occurred in 64 (12%) Periprocedural complications occurred in 23 (4.3%) and procedure-related adverse events in 23 (4.3%) patients. Multivariable analysis revealed angulation on lesion ≤90° (HR=2.18, 95% CI: 1.21–3.94, P=0.0096) and sequential lesion (HR=1.89, 95% CI: 1.01–3.54, P=0.046) as independent predictors of no clinical success of RA. Multivariable analysis revealed again that angulation on lesion ≤90° (HR=2.26, 95% CI: 1.16–4.40, P=0.02) and sequential lesion (HR=3.77, 95% CI: 1.64–8.69, PConclusions:The presence of an acute angulation on lesion and sequential lesion are independent determinants of clinical and procedural failure of RA. Further research is necessary to establish a score predicting RA failure, which can help in preproceduralrisk stratification of patients undergoing complex percutaneous coronary intervention with RA.Keywords
This publication has 31 references indexed in Scilit:
- Contemporary clinical outcomes of patients treated with or without rotational coronary atherectomy — An analysis of the UK central cardiac audit databaseInternational Journal of Cardiology, 2014
- Third Universal Definition of Myocardial InfarctionJournal of the American College of Cardiology, 2012
- Third Universal Definition of Myocardial InfarctionJournal of Invasive Cardiology, 2012
- Long‐term clinical outcome of rotational atherectomy followed by drug‐eluting stent implantation in complex calcified coronary lesionsCatheterization and Cardiovascular Interventions, 2012
- Predicting Successful Guidewire Crossing Through Chronic Total Occlusion of Native Coronary Lesions Within 30 Minutes: The J-CTO (Multicenter CTO Registry in Japan) Score as a Difficulty Grading and Time Assessment ToolJACC: Cardiovascular Interventions, 2011
- Assessment of the SYNTAX score in the Syntax studyEuroIntervention, 2009
- Stent underexpansion and residual reference segment stenosis are related to stent thrombosis after sirolimus-eluting stent implantation: An intravascular ultrasound studyJournal of Invasive Cardiology, 2005
- Coronary Artery Calcium Score Combined With Framingham Score for Risk Prediction in Asymptomatic IndividualsJAMA, 2004
- Rotational atherectomy multicenter registry: Acute results, complications and 6-month angiographic follow-up in 709 patientsJournal of Invasive Cardiology, 1994
- Relation of clinical presentation, stenosis morphology, and operator technique to the procedural results of rotational atherectomy and rotational atherectomy-facilitated angioplasty.Journal of the American College of Cardiology, 1994