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Rotapro 系统治疗严重钙化冠状动脉病变的可行性和结果:Rotapro 研究。

Feasibility and outcome of the Rotapro system in treating severely calcified coronary lesions: The Rotapro study.

机构信息

Division of Cardiology and Angiology II, University Heart Center Freiburg, Bad Krozingen, Germany.

Gottsegen György Hungarian Institute of Cardiology, Budapest, Hungary.

出版信息

Cardiol J. 2023;30(4):526-533. doi: 10.5603/CJ.a2021.0128. Epub 2021 Oct 21.

Abstract

BACKGROUND

The Rotapro study was conducted to evaluate the safety and feasibility of the new Rotapro rotational atherectomy system (RAS) for lesion preparation in calcified coronary artery stenosis.

METHODS

Between 2015 and 2019 consecutive patients undergoing rotational atherectomy (RA) with the new Rotapro system and the conventional rotablator (Rotablator) were included from the Bad Krozingen Rotablation Registry. The primary endpoint was the incidence of in-hospital major adverse cardiovascular and cerebral event (MACCE) rate.

RESULTS

Rotablation was performed in 3.6% of all patients (n = 597) treated by percutaneous coronary intervention. Procedural outcomes were compared according to the applied RAS (n = 246 Rotapro vs. n = 351 Rotablator). Overall technical success was achieved in 98.3% of patients. The primary endpoint of in-hospital MACCE was comparable between the Rotapro- and the Rotablator-group (3.7% vs. 5.7%, respectively, p = 0.254). The Rotapro group was associated with significant reductions of fluoroscopy time (30 vs. 38 min, p < 0.0001), procedural time (82.5 vs. 96 min, p = 0.0003), applied contrast volume (210 vs. 290 mL, p < 0.0001) and radiation dose (6129 vs. 9827 cGy*cm2, p < 0.0001) compared to the Rotablator group.

CONCLUSIONS

The present study demonstrates the safety and efficacy of the new Rotapro system. Inhospital MACCE rates were comparable between both RAS, whereas Rotapro was associated with less fluoroscopy time, radiation dose as well as contrast use.

摘要

背景

Rotapro 研究旨在评估新型 Rotapro 旋转切割系统(RAS)在钙化冠状动脉狭窄病变准备中的安全性和可行性。

方法

2015 年至 2019 年,连续纳入接受新型 Rotapro 系统和传统旋转切割器(Rotablator)旋转切割术(RA)的患者,来自巴特克罗岑旋转切割登记处。主要终点是院内主要不良心脑血管事件(MACCE)发生率。

结果

经皮冠状动脉介入治疗患者中,3.6%(n=597)行旋转切割术。根据应用的 RAS 比较手术结果(n=246 Rotapro 与 n=351 Rotablator)。98.3%的患者达到了总体技术成功。Rotapro 组和 Rotablator 组院内 MACCE 的主要终点无差异(分别为 3.7%和 5.7%,p=0.254)。Rotapro 组的透视时间(30 分钟比 38 分钟,p<0.0001)、手术时间(82.5 分钟比 96 分钟,p=0.0003)、造影剂用量(210 毫升比 290 毫升,p<0.0001)和辐射剂量(6129 比 9827 cGy*cm2,p<0.0001)均显著低于 Rotablator 组。

结论

本研究表明新型 Rotapro 系统的安全性和有效性。两种 RAS 的院内 MACCE 发生率无差异,而 Rotapro 与透视时间、辐射剂量和造影剂用量减少相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1416/10508079/37b7d45fe5f4/cardj-30-4-526f1.jpg

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