Usefulness of rotational atherectomy for the implantation of drug-eluting stents in the calcified lesions of hemodialysis patients

Summary Background Drug-eluting stents (DES) have significantly reduced in-stent restenosis. But the calcification of coronary artery lesions in hemodialysis patients is a high-risk factor for restenosis after DES implantation. We hypothesized that percutaneous transluminal coronary rotational ather...

Full description

Saved in:
Bibliographic Details
Published inJournal of cardiology Vol. 55; no. 2; pp. 232 - 237
Main Authors Fujimoto, Hajime, MD, PhD, Ishiwata, Sugao, MD, PhD, FJCC, Yamaguchi, Tetsu, MD, PhD, FJCC, Ohno, Minoru, MD, PhD, FJCC
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier Ltd 01.03.2010
Subjects
Aged
Atherectomy
Atherectomy, Coronary - methods
Calcinosis - pathology
Cardiovascular
Coronary Angiography
Coronary Restenosis - therapy
Coronary Vessels - pathology
Drug-Eluting Stents
Female
Humans
Male
Renal Dialysis
Restenosis
Retrospective Studies
Stent
Ultrasonography, Interventional
Restenosis
Stent
Atherectomy
Online AccessGet full text

Cover

More Information
Summary:Summary Background Drug-eluting stents (DES) have significantly reduced in-stent restenosis. But the calcification of coronary artery lesions in hemodialysis patients is a high-risk factor for restenosis after DES implantation. We hypothesized that percutaneous transluminal coronary rotational atherectomy (PTCRA) may be useful in the prevention of underexpansion and fracture of the stents, thereby reducing major adverse cardiac events. Methods We retrospectively compared the primary success and mid-term outcomes (major adverse cardiac events within 12 months) of hemodialysis patients with calcified coronary lesions undergoing DES implantation using PTCRA ( n = 26) with those where DES was implanted without PTCRA ( n = 28). Results The rates of target lesion revascularization in the PTCRA group were lower than those in the non-PTCRA group (11.5% vs 35.7%, p = 0.026). The rates of restenosis and subacute thrombosis in the PTCRA group were modestly lower than those in the non-PTCRA group (restenosis rate, 17.4% vs 17.4%, p = 0.061; subacute thrombosis rate, 0% vs 7.1%, p = 0.31). Conclusion PTCRA may be useful for improving the mid-term outcome of DES implantation in hemodialysis patients with calcified lesions.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0914-5087
1876-4738
DOI:10.1016/j.jjcc.2009.11.003