title: Incidence and Determinants of Complications in Rotational Atherectomy: Insights From the National Clinical Data (J-PCI Registry).
abstract: The usage of rotational atherectomy (RA) is growing in the current percutaneous coronary intervention (PCI) because of the expansion of PCI indication to more complex lesions. However, the complications after RA have been linked to procedure-related morbidity and mortality. The purpose of this study was to investigate the incidence and determinants of complications in RA using a large nationwide registration system in Japan (J-PCI).
  
  
  
  The primary composite outcome of this study was defined as the occurrence of in-hospital death, cardiac tamponade, and emergent surgery after RA. A total of 13 335 RA cases (3.2% of registered PCI cases) were analyzed. The composite outcome was observed in 175 cases (1.31%) and included 80 in-hospital deaths (0.60%), 86 tamponades (0.64%), and 24 emergent surgeries (0.18%). The clinical variables associated with occurrence of the composite outcome were age (odds ratio [OR] 1.03 per unit increment, 95% confidence interval [CI] 1.02-1.05), impaired kidney function (OR 1.59, 95% CI 1.15-2.19), previous myocardial infarction (OR 1.69, 95% CI 1.21-2.35), emergent PCI (OR 4.02, 95% CI 1.66-8.27), and triple-vessel disease (versus single-vessel disease: OR 2.17, 95% CI 1.43-3.28). Notably, institutional volume of RA cases was inversely associated with the composite outcomes (high- versus low-volume institution: OR 0.56, 95% CI 0.36-0.89).
  
  
  
  The reported incidence of important procedure-related complication rate was 1.3%, with each component ranging between 0.2% and 0.6% in J-PCI. Its determinants were both patient related (age, impaired kidney function, and previous myocardial infarction) and procedure related (emergent procedures, number of diseased vessels, and institutional volume of RA).
authors.affiliation: From the Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan (K.S., H. Funayama, H. Fujita, S.-i.M.); and Science and Registry Committee, Japanese Association of Cardiovascular Intervention and Therapeutics, Tokyo, Japan (T.I., S.K., T.A., S.U., H.I., K.K., M.N.). ksakakura@jichi.ac.jp.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sakakura
authors.affiliation: From the Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan (K.S., H. Funayama, H. Fujita, S.-i.M.); and Science and Registry Committee, Japanese Association of Cardiovascular Intervention and Therapeutics, Tokyo, Japan (T.I., S.K., T.A., S.U., H.I., K.K., M.N.).
authors.forename: Taku
authors.initials: T
authors.lastname: Inohara
authors.affiliation: From the Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan (K.S., H. Funayama, H. Fujita, S.-i.M.); and Science and Registry Committee, Japanese Association of Cardiovascular Intervention and Therapeutics, Tokyo, Japan (T.I., S.K., T.A., S.U., H.I., K.K., M.N.).
authors.forename: Shun
authors.initials: S
authors.lastname: Kohsaka
authors.affiliation: From the Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan (K.S., H. Funayama, H. Fujita, S.-i.M.); and Science and Registry Committee, Japanese Association of Cardiovascular Intervention and Therapeutics, Tokyo, Japan (T.I., S.K., T.A., S.U., H.I., K.K., M.N.).
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Amano
authors.affiliation: From the Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan (K.S., H. Funayama, H. Fujita, S.-i.M.); and Science and Registry Committee, Japanese Association of Cardiovascular Intervention and Therapeutics, Tokyo, Japan (T.I., S.K., T.A., S.U., H.I., K.K., M.N.).
authors.forename: Shiro
authors.initials: S
authors.lastname: Uemura
authors.affiliation: From the Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan (K.S., H. Funayama, H. Fujita, S.-i.M.); and Science and Registry Committee, Japanese Association of Cardiovascular Intervention and Therapeutics, Tokyo, Japan (T.I., S.K., T.A., S.U., H.I., K.K., M.N.).
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishii
authors.affiliation: From the Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan (K.S., H. Funayama, H. Fujita, S.-i.M.); and Science and Registry Committee, Japanese Association of Cardiovascular Intervention and Therapeutics, Tokyo, Japan (T.I., S.K., T.A., S.U., H.I., K.K., M.N.).
authors.forename: Kazushige
authors.initials: K
authors.lastname: Kadota
authors.affiliation: From the Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan (K.S., H. Funayama, H. Fujita, S.-i.M.); and Science and Registry Committee, Japanese Association of Cardiovascular Intervention and Therapeutics, Tokyo, Japan (T.I., S.K., T.A., S.U., H.I., K.K., M.N.).
authors.forename: Masato
authors.initials: M
authors.lastname: Nakamura
authors.affiliation: From the Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan (K.S., H. Funayama, H. Fujita, S.-i.M.); and Science and Registry Committee, Japanese Association of Cardiovascular Intervention and Therapeutics, Tokyo, Japan (T.I., S.K., T.A., S.U., H.I., K.K., M.N.).
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Funayama
authors.affiliation: From the Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan (K.S., H. Funayama, H. Fujita, S.-i.M.); and Science and Registry Committee, Japanese Association of Cardiovascular Intervention and Therapeutics, Tokyo, Japan (T.I., S.K., T.A., S.U., H.I., K.K., M.N.).
authors.forename: Hideo
authors.initials: H
authors.lastname: Fujita
authors.affiliation: From the Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan (K.S., H. Funayama, H. Fujita, S.-i.M.); and Science and Registry Committee, Japanese Association of Cardiovascular Intervention and Therapeutics, Tokyo, Japan (T.I., S.K., T.A., S.U., H.I., K.K., M.N.).
authors.forename: Shin-Ichi
authors.initials: SI
authors.lastname: Momomura
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017225:Atherectomy, Coronary / Q000009:adverse effects* / Q000401:mortality; D006348:Cardiac Surgical Procedures; D002305:Cardiac Tamponade / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D016009:Chi-Square Distribution; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D004630:Emergencies; D005260:Female; D017052:Hospital Mortality; D061847:Hospitals, High-Volume; D061846:Hospitals, Low-Volume; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D007674:Kidney Diseases / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology; D016017:Odds Ratio; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
keywords: atherectomy; complication; incidence; registry; rotational atherectomy