Hernández-Enríquez Marco, Campelo-Parada Francisco, Lhermusier Thibault, Bouisset Frédéric, Roncalli Jérôme, Elbaz Meyer, Carrié Didier, Boudou Nicolas
Department of Cardiology, Cardiovascular Institute, Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
Department of Cardiology, Rangueil University Hospital, Toulouse, France.
J Interv Cardiol. 2018 Aug;31(4):465-470. doi: 10.1111/joic.12491. Epub 2018 Jan 25.
To analyze the procedural and long-term outcomes of the use of rotational atherectomy (RA) in underexpanded stents in our cohort and to provide an overview of currently available data on this technique.
Stent underexpansion (SU) has been related to stent thrombosis and restenosis. RA has been used to treat undilatable SU as a bail-out strategy with encouraging results.
This is an observational, single-center study. We included patients who underwent stentablation between 2013 and 2017. Baseline demographics, procedural results, in-hospital major adverse cardiac events (MACE), and long-term follow-up MACE were retrospectively collected.
A total of 11 patients (90.9% males, mean age 65.4 ± 18.6) were included in this study. Median left ventricle ejection fraction was 53.5% [46.2-55]. Median calculated Syntax score was 16 [9-31] and 45.5% of patients were admitted for acute coronary syndrome. Radial approach was used in 63.6% of cases. Most patients only required one burr (45% used a 1.5 mm diameter burr) during the intervention. Procedural success was achieved in 90.9% of the cases. Acute lumen gain was 42.7% [30.7-61.49]. There were no in-hospital deaths or MACE. At a median follow-up of 26 months, only one patient (9.1%) suffered MACE in the context of acute coronary syndrome, and two patients (18.2%) required non-target lesion revascularization. No deaths were reported.
RA of under expanded stents is a feasible option with a high rate of procedural success. At long-term follow-up, all of them were alive and 90.9% of patients remained free from MACE.
分析在我们的队列中使用旋磨术（RA）处理未充分扩张支架的手术过程及长期结果，并概述有关该技术的现有数据。
支架未充分扩张（SU）与支架血栓形成和再狭窄有关。RA已被用作一种补救策略来治疗无法扩张的SU，结果令人鼓舞。
这是一项单中心观察性研究。我们纳入了2013年至2017年间接受支架消融的患者。回顾性收集基线人口统计学资料、手术结果、院内主要不良心脏事件（MACE）和长期随访MACE。
本研究共纳入11例患者（男性占90.9%，平均年龄65.4±18.6岁）。左心室射血分数中位数为53.5%[46.2 - 55]。计算得出的Syntax评分中位数为16[9 - 31]，45.5%的患者因急性冠状动脉综合征入院。63.6%的病例采用桡动脉途径。大多数患者在干预过程中仅需要一个磨头（45%使用直径1.5毫米的磨头）。90.9%的病例手术成功。急性管腔增益为42.7%[30.7 - 61.49]。无院内死亡或MACE。在中位随访26个月时，仅1例患者（9.1%）在急性冠状动脉综合征情况下发生MACE，2例患者（18.2%）需要进行非靶病变血管重建。无死亡报告。
对未充分扩张的支架进行RA是一种可行的选择，手术成功率高。在长期随访中，所有患者均存活，90.9%的患者无MACE。
