title: Drug-eluting versus bare metal stents after rotational atherectomy: clinical outcome in a single centre.
abstract: OBJECTIVE
  Heavily calcified atherosclerotic plaques can be prepared for stenting by rotational atherectomy (RA). Clinical outcomes with drug-eluting stents (DES) versus bare-metal stents (BMS) after RA have not been investigated sufficiently. We present a single-centre study comparing the efficacy and long-term outcome of DES versus BMS after RA.
  
  
  RESULTS
  We performed a retrospective cohort study of all patients who were treated with RA at our institution between January 2004 and March 2012. Clinical follow-up was obtained at 1 year. Procedural success (defined as a residual stenosis < 30%) was recorded, as was the 1-year incidence of myocardial infarction (MI), stent thrombosis (ST) and major adverse cardiac events (MACE), a composite end point of cardiac death, MI or target lesion revascularization (TLR). Eighty-five patients underwent RA followed by stenting, 30 receiving a BMS and 55 a DES, and completed 1-year clinical follow-up. Baseline clinical and angiographic characteristics were similar, and procedural success was achieved in 99% of the patients. At 1 year the overall incidence of MACE was 19%, and no significant differences in clinical outcome between DES and BMS were seen (MACE: 9 (16%) vs 7 (23%), P = 0.44; cardiac death: 3 (5%) vs 0 (0%); MI: 4 (7%) vs 5 (17%), P = 0.2; TLR: 2 (4%) vs 3 (10%), P = 0.25; ST: 2 (4%) vs 2 (7%), P = 0.52, respectively).
  
  
  CONCLUSIONS
  In this study, no significant differences in medium-term clinical outcomes between DES and BMS after RA were observed, although there was a definite trend to improved outcomes with DES.
authors: Rob
authors: R
authors: Bielen
authors: Johan
authors: J
authors: Bennett
authors: Bert
authors: B
authors: Ferdinande
authors: Christophe
authors: C
authors: Dubois
mesh_terms: D000368:Aged; D017225:Atherectomy, Coronary / Q000379:methods*; D003324:Coronary Artery Disease / Q000601:surgery*; D023903:Coronary Restenosis / Q000453:epidemiology; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008670:Metals; D009203:Myocardial Infarction / Q000453:epidemiology; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
chemical_list: D008670:Metals