Coronary rotational atherectomy in current practice: acute and mid-term results in high- and low-volume centers.
We conducted a prospective observational study to evaluate the indications, technique, in-hospital and 9-month results of consecutive patients treated with rotational atherectomy (RA) in 12 centers during 1 year, as well as their relationship with volume of RA activity. The study included 345 lesions in 289 patients treated (4.4% +/- 2.6% of procedures at the participating centers). The lesions were mostly calcified (63%) and type B2 or C (74%). Procedural success was obtained in 94% of patients, with a major adverse cardiac event (MACE) rate of 4.5%. At 9 months, MACE occurred in 17.3%. Multivariate analysis identified multivessel disease and slow flow as negative predictors of procedural success, whereas balloon pressure <or= 6 atm and hypercholesterolemia were associated with decreased MACE at 9 months. Center RA volume was not associated with in-hospital or 9-month outcome. We conclude that RA, even when used sporadically in selected complex lesions, can provide good immediate and mid-term results.
Rubartelli
Paolo
P
Division of Cardiology, Ospedale San Martino, Genoa, Italy. paolo.rubartelli@hsanmartino.liguria.it
Niccoli
Luigi
L
Alberti
Alessandro
A
Giachero
Corinna
C
Ettori
Federica
F
Missiroli
Bindo
B
Bernardi
Guglielmo
G
Maiello
Luigi
L
Reimers
Bernhard
B
Cernigliaro
Carmelo
C
Sardella
Gennaro
G
Bramucci
Ezio
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D017225:Atherectomy, Coronary; D019917:Blood Vessel Prosthesis Implantation; D017023:Coronary Angiography; D003327:Coronary Disease / Q000601:surgery; D023903:Coronary Restenosis / Q000209:etiology / Q000401:mortality / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006742:Hospital Bed Capacity; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality / Q000628:therapy; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000628:therapy; D011446:Prospective Studies; D012086:Reoperation; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome