title: [Efficacy of intravascular ultrasound guided rotational atherectomy for heavily calcified coronary lesions].
abstract: OBJECTIVE
  To evaluate the efficacy of intravascular ultrasound guided tranradial rotational atherectomy (RA) followed by drug eluting stent (DES) implantation in treating patients with heavily calcified coronary lesions.
  
  
  METHODS
  Clinical characteristics, coronary angiogram, intravascular ultrasound images, peri-procedure and follow-up data (including death , myocardial infarction and target lesion revascularization) of 44 patients treated with RA and DES implantation under the guidance of IVUS in our department from March 2011 to March 2013 were retrospectively analyzed. IVUS examination was carried out before RA, after RA and stent implantation to guide whether further RA or post dilatation was needed. According to the arc of calcification, the patients were divided into group A (90°-270°, 18 cases) and group B (271°-360°, 26 cases).
  
  
  RESULTS
  In A and B group, the arc of calcification was (195 ± 71)° in group A and (345 ± 23)° in group B (P < 0.01) , length of calcification was (34.4 ± 11.8) mm in group A and (20.0 ± 6.6) mm in group B (P < 0.05). Number of burrs used and size of largest burr used were similar between 2 groups (both P > 0.05). Acute cross sectional area gain after RA was (0.43 ± 0.32) mm in group A and (0.53 ± 0.38) mm² in group B (P > 0.05). After RA, there was significant decrease in the arc of calcification in group B compared with baseline ((324 ± 52)° vs. (345 ± 23)°, P < 0.05). The minimal lumen area and diameter were significantly increased after RA resulting in significant decrease in the plaque burden in both groups (all P < 0.05). The final minimal lumen area after stenting were similar between 2 groups (P > 0.05). Procedure success rate was 100% (44/44) without any major complications such as death, acute myocardial infarction and coronary perforation. During the (16.6 ± 6.3) months follow-up, there was 1 death in group A, 1 target lesion revascularization in group B and there was no acute myocardial infarction in the 2 groups.
  
  
  CONCLUSIONS
  Heavily calcified coronary lesions can be effectively and safely treated by transradial RA under the guidance of IVUS.
authors.affiliation: Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Jiang
authors.affiliation: Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.
authors.forename: Guozhong
authors.initials: G
authors.lastname: Zhu
authors.affiliation: Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.
authors.forename: Changling
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Dong
authors.affiliation: Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.
authors.forename: Xianbao
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Lyu
authors.affiliation: Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.
authors.forename: Xinyang
authors.initials: X
authors.lastname: Hu
authors.affiliation: Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.
authors.forename: Meixiang
authors.initials: M
authors.lastname: Xiang
authors.affiliation: Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China. Email: wja@zju.edu.cn.
authors.forename: Jian'an
authors.initials: J
authors.lastname: Wang
mesh_terms: D017225:Atherectomy, Coronary; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000628:therapy*; D054855:Drug-Eluting Stents; D006801:Humans; D009203:Myocardial Infarction; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D061205:Vascular Calcification / Q000628:therapy