Faculty of Health Sciences and Physical Culture, Witelon Collegium State University, 59-220 Legnica, Poland.
Department of Cardiology, Provincial Specialized Hospital, 59-220 Legnica, Poland.
Int J Environ Res Public Health. 2022 Jul 25;19(15):9011. doi: 10.3390/ijerph19159011.
The unprotected calcified Left Main disease represents a high-risk subset for percutaneous coronary intervention (PCI), and it is associated with a higher number of periprocedural complications and an increased rate of in-stent thrombosis and restenosis. Adequate lesion preparation plays a crucial role in achieving a favorable PCI outcome. Rotational Atherectomy (RA) is a well-established plaque-modifying method; nevertheless, the data regarding the effectiveness of RA in LM diseases is scarce. Recently, the novel ShockWave-Intravascular-Lithotripsy(S-IVL) device has been introduced to the PCI armamentarium in order to modify the calcified plaque.
We performed a retrospective evaluation of 44 consecutive subjects who underwent the LM-PCI, and who were supported by either the RA or S-IVL.
The Rota group consisted of 29 patients with a mean syntax score of 28.0 ± 7.5. The S-IVL group was composed of 15 subjects with a syntax score of 23.3 ± 13.0 There were no statistical differences regarding MACE between the RA and Shockwave arms of the in-hospital group (10.3% vs. 6.7%), or in the six month (17.2% vs. 13.3%) follow-up group.
RA and S-IVL could be safe and effective therapeutic strategies for calcified LM disease. Further studies with a higher number of participants and longer follow-up times are warranted to establish the potential benefits of RA and S-IVL for the management of LM stenosis.
无保护的左主干钙化病变是经皮冠状动脉介入治疗（PCI）的高危亚组，与围手术期并发症的发生率更高、支架内血栓形成和再狭窄的发生率增加有关。充分的病变准备在实现良好的 PCI 结果中起着至关重要的作用。旋磨术（RA）是一种成熟的斑块修饰方法；然而，关于 RA 在 LM 疾病中的有效性的数据却很少。最近，新型的冲击波血管内碎石术（S-IVL）设备已被引入 PCI 治疗手段，以修饰钙化斑块。
我们对 44 例连续接受 LM-PCI 治疗的患者进行了回顾性评估，这些患者分别接受了 RA 或 S-IVL 治疗。
RA 组由 29 例患者组成，平均Syntax 评分 28.0 ± 7.5。S-IVL 组由 15 例患者组成，Syntax 评分 23.3 ± 13.0。在住院期间（10.3% vs. 6.7%）或 6 个月（17.2% vs. 13.3%）随访期间，RA 和 Shockwave 组之间的主要不良心脏事件（MACE）没有统计学差异。
RA 和 S-IVL 可能是治疗钙化 LM 疾病的安全有效的治疗策略。需要进一步的研究，纳入更多的参与者和更长的随访时间，以确定 RA 和 S-IVL 在 LM 狭窄管理中的潜在益处。
