Rotational atherectomy followed by drug-eluting stent implantation in calcified coronary lesions

• Published in: EuroIntervention Vol. 5; no. 3; pp. 370 - 374
• Main Authors: FURUICHI, Shinichi, SANGIORGI, Giuseppe M, GODINO, Cosmo, AIROLDI, Flavio, MONTORFANO, Matteo, CHIEFFO, Alaide, MICHEV, Iassen, CARLINO, Mauro, COLOMBO, Antonio
• Format: Journal Article
• Language: English
• Published: Toulouse Société Europa Edition 01.08.2009
• Subjects: Aged; Angioplasty, Balloon, Coronary - adverse effects; Angioplasty, Balloon, Coronary - instrumentation; Angioplasty, Balloon, Coronary - mortality; Atherectomy, Coronary; Biological and medical sciences; Calcinosis - diagnostic imaging; Calcinosis - mortality; Calcinosis - therapy; Cardiology. Vascular system; Cardiovascular Diseases - etiology; Cineangiography; Coronary Angiography; Coronary heart disease; Coronary Stenosis - diagnostic imaging; Coronary Stenosis - mortality; Coronary Stenosis - therapy; Drug-Eluting Stents; Feasibility Studies; Female; Heart; Humans; Male; Medical sciences; Middle Aged; Retrospective Studies; Severity of Illness Index; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Thrombosis - etiology; Time Factors; Treatment Outcome; Endoprosthesis; Atherectomy; Calcified coronary lesions; rotational atherectomy; stents; Coronary artery; Cardiovascular disease; Implantation; Lesion; Coronary heart disease; Drug eluting stent
• ISSN: 1774-024X
• DOI: 10.4244/v5i3a58

Little information is available on the outcome after rotational atherectomy (RA) followed by drug-eluting stent (DES) implantation in calcified coronary lesions. The aim of this study was to evaluate the outcome of patients with severe lesion calcification undergoing RA followed by implantation of DES. Ninety-five patients with 96 de novo severely calcified lesions were included. Twenty-nine patients (30.5%) had diabetes mellitus and seven patients (7.4%) had chronic renal failure. The total stent length per lesion was 48.4+/-24.9 mm. Procedural success rate was 95.8%. The incidence of cumulative major adverse cardiac events, defined as death, myocardial infarction (MI) and target vessel revascularisation (TVR), was 15.8% at the mean follow-up period of 14.7 months (range 6.0-57.7). Death occurred in four patients (4.2%). Non Q-wave MI occurred in 3 patients (3.2%) and Q-wave MI occurred in two patients (2.1%). The rate of target lesion revascularisation (TLR) was 9.5%. The rate of TVR was 11.6%. Two definite (2.1%) and 2 possible (2.1%) stent thromboses were observed. RA followed by DES implantation in severely calcified coronary lesions appears to be feasible including high rate of procedural success and low-incidence of TLR considering this complex lesion subset.