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“RotaTripsy”治疗严重钙化冠状动脉病变:来自真实世界多中心队列的研究结果。

"RotaTripsy" for Severe Calcified Coronary Artery Lesions: Insights From a Real-World Multicenter Cohort.

机构信息

Clinical and Interventional Cardiology Unit, Istituto Clinico Sant'Ambrogio, Gruppo Ospedaliero San Donato, Milan, Italy.

Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust Birmingham, UK.

出版信息

Cardiovasc Revasc Med. 2022 Apr;37:78-81. doi: 10.1016/j.carrev.2021.06.132. Epub 2021 Jul 2.

Abstract

OBJECTIVES

The aim of this study is to assess the feasibility, efficacy and safety of the "RotaTripsy" approach in severe calcified coronary artery lesions.

BACKGROUND

Coronary lesions with a high calcium content represent a challenging scenario in interventional cardiology, requiring a proper lesion preparation. In this light, very little is known about the possibility to combine the benefits of rotational atherectomy and intravascular lithotripsy.

METHODS

We retrospectively enrolled 34 patients from a real-word, multicenter, cohort of patients affected by severe calcified coronary artery lesions, which required the "RotaTripsy" to obtain a proper lesion preparation. In all the cases, rotational atherectomy and then intravascular lithotripsy were performed as a bail-out strategy following sub-optimal non-compliant balloon expansion. In 53% of the cases, the procedure was guided by intracoronary imaging findings.

RESULTS

Procedural success was reported in all the cases, without any in-hospital major complication. Few major adverse clinical events were reported at mid-term follow-up.

CONCLUSIONS

"RotaTripsy" can represent a valid therapeutic option for undilatable heavily calcified coronary artery lesions. Our findings demonstrate the feasibility, safety and efficacy of this approach.

摘要

目的

本研究旨在评估“RotaTripsy”方法在严重钙化冠状动脉病变中的可行性、疗效和安全性。

背景

富含钙的冠状动脉病变是介入心脏病学中的一个具有挑战性的情况,需要对病变进行适当的准备。在这方面,对于将旋转切割术和血管内碎石术的优势相结合的可能性,我们知之甚少。

方法

我们回顾性地纳入了来自一个真实世界、多中心队列的 34 名严重钙化冠状动脉病变患者,这些患者需要“RotaTripsy”来获得适当的病变准备。在所有病例中,在非顺应性球囊扩张效果不理想的情况下,作为挽救策略,先进行旋转切割术,然后进行血管内碎石术。在 53%的病例中,该过程是根据冠状动脉内影像学结果进行指导的。

结果

所有病例均报告了手术成功,无院内重大并发症。中期随访时报告了少数重大不良临床事件。

结论

“RotaTripsy”可能是一种治疗不可扩张的严重钙化冠状动脉病变的有效治疗选择。我们的研究结果表明了这种方法的可行性、安全性和疗效。

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