Association between debulking area of rotational atherectomy and platform revolution speed-Frequency domain optical coherence tomography analysis
- 1 January 2020
- journal article
- research article
- Published by Wiley in Catheterization and Cardiovascular Interventions
- Vol. 95 (1), E1-E7
- https://doi.org/10.1002/ccd.28212
Abstract
Objectives In this study, we sought to investigate the association between revolution speed of rotational atherectomy (RA) and debulking area assessed by frequency domain-optical coherence tomography (FD-OCT). Background The number of patients with severe calcified coronary artery disease requiring treatment with calcium ablation, such as RA, is increasing. However, there is little evidence available regarding the association between debulking area and revolution speed during RA. Methods We retrospectively investigated 30 consecutive severely calcified coronary lesions in 29 patients who underwent RA under FD-OCT guidance. The association between preset revolution speed of RA and burr size-corrected debulking area of the calcified lesion was evaluated using a multivariable regression model with nonlinear restricted-cubic-spline, which can help assess nonlinear associations between variables. Results The median age of study participants was 73 years (quartile 65-78); 82.8% were male. The median burr size was 1.5 mm (1.5-1.75); median total duration of ablation was 120 s (100-180). FD-OCT revealed that the post-procedural minimum lumen area increased significantly from 1.64 mm(2) (1.40-2.09) to 2.45 mm(2) (2.11-2.98) (p < .001). In addition, the burr size-corrected debulking area increased significantly as the preset revolution speed decreased (p = .018), especially when the revolution speed was less than 150,000 rpm. This result implies that additional lumen gain will be obtained by decreasing rpm when the burr speed is set at <150,000 rpm. Conclusions FD-OCT demonstrated that RA with lower revolution speed, below 150,000 rpm, has the potential to achieve greater calcium debulking effect in patients with severe calcified coronary lesions.This publication has 27 references indexed in Scilit:
- High-Speed Rotational Atherectomy Before Paclitaxel-Eluting Stent Implantation in Complex Calcified Coronary Lesions: The Randomized ROTAXUS (Rotational Atherectomy Prior to Taxus Stent Treatment for Complex Native Coronary Artery Disease) TrialJACC: Cardiovascular Interventions, 2013
- Long‐term clinical outcome of rotational atherectomy followed by drug‐eluting stent implantation in complex calcified coronary lesionsCatheterization and Cardiovascular Interventions, 2012
- Consensus Standards for Acquisition, Measurement, and Reporting of Intravascular Optical Coherence Tomography Studies: A Report From the International Working Group for Intravascular Optical Coherence Tomography Standardization and ValidationJournal of the American College of Cardiology, 2012
- 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and InterventionsJournal of the American College of Cardiology, 2011
- Assessment of the coronary calcification by optical coherence tomographyEuroIntervention, 2011
- Dose‐response analyses using restricted cubic spline functions in public health researchStatistics in Medicine, 2010
- Assessing the Performance of Prediction ModelsEpidemiology, 2010
- Advantage of next‐generation frequency‐domain optical coherence tomography compared with conventional time‐domain system in the assessment of coronary lesionCatheterization and Cardiovascular Interventions, 2009
- Beneficial effect of rotational atherectomy with low platform speed on late outcomesInternational Journal of Cardiology, 2004
- Mechanisms of Residual Lumen Stenosis After High-Pressure Stent ImplantationCirculation, 1998