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.
Cardiovasc Revasc Med. 2022 Apr;37:78-81. doi: 10.1016/j.carrev.2021.06.132. Epub 2021 Jul 2.
The aim of this study is to assess the feasibility, efficacy and safety of the "RotaTripsy" approach in severe calcified coronary artery lesions.
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.
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.
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.
"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.
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。
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。
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。
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。
“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。