title: Comparison of Clinical and Angiographic Outcomes After Bare Metal Stents and Drug-Eluting Stents Following Rotational Atherectomy.
abstract: Few studies have investigated the clinical outcomes of rotational atherectomy (RA) prior to and during the drugeluting stent (DES) era. The goal of this study was to assess the long-term outcome after RA followed by DES and bare metal stent (BMS) implantation in complex calcified coronary lesions and to compare the outcomes among various DESs.This was a single center retrospective observational study. Consecutive 406 patients who underwent elective RA followed by BMS or DES implantation at our institution from 2001 to 2011 were included. This study compared the long-term outcomes after treatment with RA among BMS and 3 different DESs (sirolimus-eluting stent, paclitaxel-eluting stent, and everolimus-eluting stent) implantation.The mean follow-up period was 4.6 years. Patients with DES were older and exhibited more vessel disease, longer lesion length, and smaller vessel size. Patients with BMS had a significantly higher rate of target lesion revascularization, restenosis, and larger late lumen loss than those with DES. Composite events including mortality, ACS, and target vessel revascularization were significantly higher in the BMS-RA group than in the DES-RA group. After adjustment, BMS remained an independent predictor of MACE and ACS plus death in patients treated with RA. However, there were no significant differences in late lumen loss, restenosis rate, and MACE among the 3 DES.The combination of DES-RA has a favorable effect in both the angiographic and clinical outcomes compared with BMS-RA. However, no significant differences in late loss and events rates were observed among the 3 DES groups.
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tamura
authors.forename: Katsumi
authors.initials: K
authors.lastname: Miyauchi
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Dohi
authors.forename: Shuta
authors.initials: S
authors.lastname: Tsuboi
authors.forename: Manabu
authors.initials: M
authors.lastname: Ogita
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kasai
authors.forename: Iwao
authors.initials: I
authors.lastname: Okai
authors.forename: Yoshiteru
authors.initials: Y
authors.lastname: Katoh
authors.forename: Tadashi
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Ryo
authors.initials: R
authors.lastname: Naito
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Konishi
authors.forename: Ken
authors.initials: K
authors.lastname: Yokoyama
authors.forename: Shinya
authors.initials: S
authors.lastname: Okazaki
authors.forename: Kikuo
authors.initials: K
authors.lastname: Isoda
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kurata
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
mesh_terms: D000368:Aged; D017225:Atherectomy, Coronary; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D054855:Drug-Eluting Stents; D000068338:Everolimus / Q000494:pharmacology; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology*; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D017239:Paclitaxel / Q000494:pharmacology; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D020123:Sirolimus / Q000494:pharmacology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus; D017239:Paclitaxel; D020123:Sirolimus