Coronary rotational atherectomy in current practice: acute and mid-term results in high- and low-volume centers

Catheter Cardiovasc Interv. 2004 Apr;61(4):463-71. doi: 10.1002/ccd.20004.

Abstract

We conducted a prospective observational study to evaluate the indications, technique, in-hospital and 9-month results of consecutive patients treated with rotational atherectomy (RA) in 12 centers during 1 year, as well as their relationship with volume of RA activity. The study included 345 lesions in 289 patients treated (4.4% +/- 2.6% of procedures at the participating centers). The lesions were mostly calcified (63%) and type B2 or C (74%). Procedural success was obtained in 94% of patients, with a major adverse cardiac event (MACE) rate of 4.5%. At 9 months, MACE occurred in 17.3%. Multivariate analysis identified multivessel disease and slow flow as negative predictors of procedural success, whereas balloon pressure <or= 6 atm and hypercholesterolemia were associated with decreased MACE at 9 months. Center RA volume was not associated with in-hospital or 9-month outcome. We conclude that RA, even when used sporadically in selected complex lesions, can provide good immediate and mid-term results.

Publication types

  • Comparative Study
  • Evaluation Study
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon, Coronary
  • Atherectomy, Coronary*
  • Blood Vessel Prosthesis Implantation
  • Coronary Angiography
  • Coronary Disease / surgery
  • Coronary Restenosis / etiology
  • Coronary Restenosis / mortality
  • Coronary Restenosis / therapy
  • Female
  • Follow-Up Studies
  • Hospital Bed Capacity*
  • Hospital Mortality
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Infarction / etiology
  • Myocardial Infarction / mortality
  • Myocardial Infarction / therapy
  • Postoperative Complications / etiology
  • Postoperative Complications / mortality
  • Postoperative Complications / therapy
  • Prospective Studies
  • Reoperation
  • Stents
  • Time Factors
  • Treatment Outcome