Early and Intermediate Outcomes After Rotational Atherectomy in Octogenarian Patients.
OBJECTIVE: To provide information about the use of rotational atherectomy in octogenarians. MATERIAL AND METHODS: From 1993-1996, 26 octogenarians underwent coronary intervention with rotablator at Emory University Hospitals. The total number of lesions were 28 (57% of them in the left artery descending). Adjunctive balloon angioplasty was utilized in 26 lesions. The lesions were eccentric in 82%, calcified in 75%, with a mean length of 10.2Â+/-8.5 mm. RESULTS: The angiographic success rate was 96.2%. The only in-hospital complications was the death of 1 patient (3.8%) after an abrupt closure, and a dissection of 1 lesion of another patient, with a favorable subsequent outcome. The mean follow up was 1.3Â+/-0.4 years. The Kaplan-Meier survival rate at 1 year was 96.2% and at 2 years 78.3%. The freedom from death, myocardial infarction (MI), and coronary artery bypass graft (CABG) was 88.5% at 1 year and 59.7 % at 1.5 and 2 years. The freedom from death, MI, CABG, and percutaneous transluminal coronary angioplasty (PTCA) was 69.2% at one year and 36.3% at 1.5 and 2 years. CONCLUSIONS: In octogenarians with complex lesions, rotablator was performed in conjunction with balloon angioplasty, and showed a high rate of angiographic success, a relatively low complication rate, and a favorable 2 years survival rate. Nevertheless, the event free rates did not show the same favorable evolution after 1 year. If feasible, it would be useful to conduct randomized trials in the elderly to compare interventional procedures to medical treatment or surgery. (c)1999 by CVRR, Inc.
Gravina Taddei
Claudia F.
CF
Dante Pazzanese Institute of Cardiology, Brazil; and the Division of Cardiology, Emory Center for Outcomes Research, Emory University, Atlanta, GA.
Weintraub
William S.
WS
King
Spencer
S
Ghazzal
Ziyad
Z
Douglas
John S.
JS
Thompson
Trevor
T
Mahoney
Elizabeth
E