Rotational atherectomy followed by drug-eluting stent implantation in calcified coronary lesions.
OBJECTIVE
Little information is available on the outcome after rotational atherectomy (RA) followed by drug-eluting stent (DES) implantation in calcified coronary lesions. The aim of this study was to evaluate the outcome of patients with severe lesion calcification undergoing RA followed by implantation of DES.


RESULTS
Ninety-five patients with 96 de novo severely calcified lesions were included. Twenty-nine patients (30.5%) had diabetes mellitus and seven patients (7.4%) had chronic renal failure. The total stent length per lesion was 48.4+/-24.9 mm. Procedural success rate was 95.8%. The incidence of cumulative major adverse cardiac events, defined as death, myocardial infarction (MI) and target vessel revascularisation (TVR), was 15.8% at the mean follow-up period of 14.7 months (range 6.0-57.7). Death occurred in four patients (4.2%). Non Q-wave MI occurred in 3 patients (3.2%) and Q-wave MI occurred in two patients (2.1%). The rate of target lesion revascularisation (TLR) was 9.5%. The rate of TVR was 11.6%. Two definite (2.1%) and 2 possible (2.1%) stent thromboses were observed.


CONCLUSIONS
RA followed by DES implantation in severely calcified coronary lesions appears to be feasible including high rate of procedural success and low-incidence of TLR considering this complex lesion subset.
Furuichi
Shinichi
S
Invasive Cardiology Unit, San Raffaele Scientific Institute and EMO Centro Cuore Columbus, Milan, Italy. shinichi.furuichi@gmail.com
Sangiorgi
Giuseppe M
GM
Godino
Cosmo
C
Airoldi
Flavio
F
Montorfano
Matteo
M
Chieffo
Alaide
A
Michev
Iassen
I
Carlino
Mauro
M
Colombo
Antonio
A
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D017225:Atherectomy, Coronary; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D002318:Cardiovascular Diseases / Q000209:etiology; D002932:Cineangiography; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D054855:Drug-Eluting Stents; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013927:Thrombosis / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome