Gorol Jaroslaw, Tajstra Mateusz, Hudzik Bartosz, Lekston Andrzej, Gąsior Mariusz
Third Department of Cardiology, SMDZ in Zabrze, Silesian Center for Heart Disease, Medical University of Silesia in Katowice, Poland.
Postepy Kardiol Interwencyjnej. 2018;14(2):128-134. doi: 10.5114/aic.2018.76403. Epub 2018 Jun 19.
Revascularization of patients with heavily calcified coronary arteries can be a challenge for interventional cardiologists. The procedural success rate in these patients can be improved by using rotational atherectomy (RA).
To compare in-hospital outcomes and those at 12-month follow-up between patients who underwent RA as a bailout procedure secondary to failed conventional angioplasty or as an elective procedure.
This is a retrospective analysis of 156 consecutive patients hospitalized at a high-volume percutaneous coronary intervention (PCI) center who underwent RA. In 43 (27.6%) patients, RA was performed on an elective basis (group 1). In 113 (72.4%) patients RA was carried out after unsuccessful traditional angioplasty (group 2).
Patients in group 1 more often had a history of peripheral vascular disease (32.6% vs. 15.9%; = 0.03). Group 1 was dominated by patients with multivessel disease (62.8% vs. 33.6%; < 0.001). The left main coronary artery was more often treated in group 1 (25.6% vs. 2.7%; < 0.001). Success rates in the two groups were similar: 93.0% for group 1 and 91.2% for group 2 ( = 0.71). The rate of in-hospital complications did not significantly differ between the groups. Twelve-month MI, TLR, and TVR rates were similar in both groups. There was no difference in the 12-month survival rate (86.1% vs. 92.0% in group 2; = 0.27) or MACE (16.3% vs. 15.0%; = 0.8).
Rotational atherectomy is associated with high efficacy and a relatively low risk of complications, with no significant differences in outcomes between patients treated with primary and secondary RA procedures.
对于介入心脏病学家而言，严重钙化冠状动脉患者的血管重建可能是一项挑战。使用旋磨术（RA）可提高这些患者的手术成功率。
比较因传统血管成形术失败而接受RA作为补救手术的患者与接受择期RA手术的患者的住院结局及12个月随访结局。
这是一项对在一家高容量经皮冠状动脉介入治疗（PCI）中心住院并接受RA的156例连续患者的回顾性分析。43例（27.6%）患者接受择期RA（第1组）。113例（72.4%）患者在传统血管成形术失败后接受RA（第2组）。
第1组患者外周血管疾病史更为常见（32.6%对15.9%；P = 0.03）。第1组以多支血管病变患者为主（62.8%对33.6%；P < 0.001）。第1组更常治疗左主干冠状动脉（25.6%对2.7%；P < 0.001）。两组成功率相似：第1组为93.0%，第2组为91.2%（P = 0.71）。两组住院并发症发生率无显著差异。两组12个月时的心肌梗死、靶病变血运重建（TLR）和靶血管血运重建（TVR）发生率相似。12个月生存率（第2组为92.0%，第1组为86.1%；P = 0.27）或主要不良心血管事件（MACE）发生率（16.3%对15.0%；P = 0.8）无差异。
旋磨术疗效高且并发症风险相对较低，原发性和继发性RA手术治疗的患者结局无显著差异。
