Department of Cardiology, Rangueil Toulouse University Hospital, Toulouse, France.
EuroIntervention. 2020 Jul 17;16(4):e305-e312. doi: 10.4244/EIJ-D-19-01129.
Despite the use of rotational atherectomy (RA) in interventional cardiology for over three decades, data regarding factors affecting the clinical outcomes of the RA procedure remain scarce. The aim of the present study was to describe the contemporary use and outcomes of RA in Europe.
We conducted, for the first time, a prospective international registry in 8 European countries and 19 centres and included patients treated by percutaneous coronary intervention with RA. Between October 2016 and July 2018, 966 patients with complete data were recruited. Mean age was 74.5 years, 72.4% were male and 43.4% had diabetes. Initial presentation was an acute coronary syndrome (ACS) for 25.1% of the patients. Clinical success was observed in 91.9% of the procedures. The rate of in-hospital major adverse cardiac events (MACE) - defined as cardiovascular death, myocardial infarction, target lesion revascularisation, stroke and coronary artery bypass grafting - was 4.7%. At one year, the rate of MACE was 13.2%. Factors independently associated with the occurrence of MACE at one year were female gender, renal failure, ACS at admission, depressed left ventricular ejection fraction (LVEF) and presence of a significant left main coronary artery (LMCA) lesion.
Despite the high level of complexity of the studied population, RA turned out to be an effective procedure with a low rate of in-hospital complications and demonstrated good immediate and midterm results.
尽管旋转血管成形术（RA）在介入心脏病学中已经使用了三十多年，但关于影响 RA 手术临床结果的因素的数据仍然很少。本研究的目的是描述 RA 在欧洲的当代应用和结果。
我们首次在 8 个欧洲国家和 19 个中心进行了一项前瞻性国际注册研究，并纳入了接受 RA 经皮冠状动脉介入治疗的患者。2016 年 10 月至 2018 年 7 月期间，共招募了 966 例有完整数据的患者。平均年龄为 74.5 岁，72.4%为男性，43.4%患有糖尿病。初始表现为 25.1%的患者为急性冠脉综合征（ACS）。91.9%的手术达到临床成功。住院期间主要不良心脏事件（MACE）的发生率为 4.7%，定义为心血管死亡、心肌梗死、靶病变血运重建、卒中和冠状动脉旁路移植术。一年时，MACE 的发生率为 13.2%。与一年时发生 MACE 相关的独立因素包括女性、肾功能衰竭、入院时的 ACS、左心室射血分数（LVEF）降低和存在显著的左主干冠状动脉（LMCA）病变。
尽管研究人群的复杂性很高，但 RA 仍然是一种有效的治疗方法，其住院并发症发生率低，并显示出良好的即刻和中期结果。
