title: Sirolimus-eluting stents and calcified coronary lesions: clinical outcomes of patients treated with and without rotational atherectomy.
abstract: This study examined the outcomes of patients who underwent sirolimus-eluting stent (SES) implantation for the treatment of heavily calcified coronary lesions (HCCL) with and without the use of rotational atherectomy (rotablator). We investigated 150 consecutive patients with angiographic evidence of HCCL who underwent SES implantation. Sixty-nine patients underwent SES implantation without the need of rotablator (SES), and 81 patients required rotational atherectomy to modify the plaque and facilitate the delivery of the stent (SES + rotational atherectomy). Clinical success was equivalent in both groups (>98%) and there were no in-hospital outcome differences. At 6 months, the target lesion revascularization rate was 4.9% in SES vs. 4.2% in SES + rotational atherectomy groups, respectively (P = NS). Mortality at 6 months was 7.9% in the SES group vs. 6.8% in the SES + rotational atherectomy group (P = NS). SES performs well in patients with complex HCCL, with a relative low event rate. Lesions requiring rotational atherectomy to facilitate dilation and stenting had similar outcomes after SES implantation to those that could be stented without the need for rotablator.
authors.affiliation: Division of Cardiology, Washington Hospital Center, Washington, DC 20010, USA.
authors.forename: Leonardo C
authors.initials: LC
authors.lastname: Clavijo
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Steinberg
authors.forename: Rebecca
authors.initials: R
authors.lastname: Torguson
authors.forename: Pramod K
authors.initials: PK
authors.lastname: Kuchulakanti
authors.forename: William W
authors.initials: WW
authors.lastname: Chu
authors.forename: Jana
authors.initials: J
authors.lastname: Fournadjiev
authors.forename: Lowell F
authors.initials: LF
authors.lastname: Satler
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Kent
authors.forename: William O
authors.initials: WO
authors.lastname: Suddath
authors.forename: Ron
authors.initials: R
authors.lastname: Waksman
authors.forename: Augusto D
authors.initials: AD
authors.lastname: Pichard
mesh_terms: D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D017225:Atherectomy, Coronary; D002114:Calcinosis / Q000188:drug therapy / Q000601:surgery*; D023903:Coronary Restenosis / Q000517:prevention & control; D023921:Coronary Stenosis / Q000188:drug therapy / Q000601:surgery*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D020123:Sirolimus