title: Drug-eluting stents following rotational atherectomy for heavily calcified coronary lesions: long-term clinical outcomes.
abstract: BACKGROUND
  Rotational atherectomy followed by drug-eluting stent (DES) implantation for complex, severely calcified lesions is a rational combination that has not been sufficiently evaluated.
  
  
  METHODS
  We investigated 102 consecutive patients with angiographic evidence of heavily calcified lesions that underwent DES implantation following rotational atherectomy at our institution between June 2005 and October 2009, and we examined the long-term clinical outcomes. The major adverse cardiac events monitored were death, myocardial infarction and target lesion revascularization.
  
  
  RESULTS
  Patients were 68.8 ± 7.4 years old, 52.9% were diabetic, and 12.7% had chronic kidney disease. Forty-seven patients (46.1%) had three-vessel disease, and 13 (12.7%) had left main coronary artery stenosis. The radial approach was used in 37.3% of cases. The procedure was successful in 97%. In-hospital death occurred in 1 patient (0.9%), and 3 patients (2.9%) developed stent thrombosis. At the mean follow-up period of 15 months (range 1- 54), the total cardiac death rate was 4.9%, target lesion revascularization was 8.8% and the incidence of myocardial infarction was 3.9%. The combined endpoint occurred in 12.7% of cases.
  
  
  CONCLUSIONS
  DES following rotational atherectomy for heavily calcified coronary lesions is a safe and effective procedure that provides good long-term clinical outcomes.
authors.affiliation: Department of Cardiology, Hospital Universitario Virgen del Rocio, Avenida Manuel Siurot s/n, 41013 Seville, Spain. javbenezet@hotmail.com
authors.forename: Javier
authors.initials: J
authors.lastname: Benezet
authors.forename: Luis Salvador
authors.initials: LS
authors.lastname: Díaz de la Llera
authors.forename: Jose María
authors.initials: JM
authors.lastname: Cubero
authors.forename: Manuel
authors.initials: M
authors.lastname: Villa
authors.forename: Mónica
authors.initials: M
authors.lastname: Fernández-Quero
authors.forename: Angel
authors.initials: A
authors.lastname: Sánchez-González
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017225:Atherectomy, Coronary; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000517:prevention & control; D003331:Coronary Vessels / Q000473:pathology; D003925:Diabetic Angiopathies / Q000401:mortality / Q000628:therapy; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome