title: Comparison of early and recent results with rotational atherectomy.
abstract: OBJECTIVE
  We compared an early registry of rotational atherectomy with a recent registry to examine the evolution of patient profiles, lesion characteristics and procedural outcomes for patients treated with rotational atherectomy.
  
  
  BACKGROUND
  With increased experience, the selection of patients and lesions treated with a device matures. This study documents the changes in the application of rotational atherectomy.
  
  
  METHODS
  The patient characteristics and procedural outcomes from two multicenter patient registries-Registry I: 2,953 procedures, 3,717 lesions from 1988 to 1993; and Registry II: 200 procedures, 268 lesions from 1994-were analyzed and compared.
  
  
  RESULTS
  There was an increase in the average age of the patients (63 vs. 65 years, p < 0.02) and the proportion of patients with unstable angina (42.9% vs. 56.5%, p < 0.01) or previous coronary artery bypass graft surgery (18.8% vs. 24.5%, p < 0.05) in Registry II. Registry II included fewer left anterior descending coronary lesions (46.5% vs. 32.8%, p < 0.01), more type B and C lesions (83.1% vs. 91.8%, p < 0.01), more eccentric lesions (69.0% vs. 79.5%, p < 0.01) and more calcified lesions (50.3% vs. 69.4%, p < 0.01). Complications, including urgent bypass surgery, Q and non-Q wave myocardial infarction, dissection, acute occlusion and perforation, were similar in the two groups. However, mortality increased from 1.0% to 3.0% (p < 0.05) in Registry II.
  
  
  CONCLUSIONS
  Comparison of recent and early patients treated with rotational atherectomy revealed an increase in the complexity of patients and lesions. Although the rate of death was increased, the overall rate of major complications was not significantly changed (4.7% vs. 6.0%, p = NS).
authors.affiliation: Swedish Medical Center, Seattle, Washington, USA.
authors.forename: M
authors.initials: M
authors.lastname: Reisman
authors.forename: V
authors.initials: V
authors.lastname: Harms
authors.forename: P
authors.initials: P
authors.lastname: Whitlow
authors.forename: T
authors.initials: T
authors.lastname: Feldman
authors.forename: R
authors.initials: R
authors.lastname: Fortuna
authors.forename: M
authors.initials: M
authors.lastname: Buchbinder
mesh_terms: D000368:Aged; D017225:Atherectomy, Coronary; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011183:Postoperative Complications; D013997:Time Factors; D016896:Treatment Outcome