కార్డియోవాస్కులర్ డిసీజెస్ & డయాగ్నోసిస్

Analysis of Coronary Artery Rotational Atherectomy: A Single Centre Study

Abstract

Patted SV, Porwal SC, Ambar S, Prasad MR, Nukavarapu VB, Hesrur V, Patil V and Atharga S

Background: Rotational Atherectomy (RA) is a valuable tool for treating severely calcified complex coronary artery disease in the Cardiac Cath lab despite a lot of helpful techniques and devices, but this is under used now due to technique demands and non-superior outcomes. The aim of our study was to evaluate the procedural and clinical outcomes of patients with complex severely calcified lesions treated by RA in the current era.

Materials and methods: This retrospective study was conducted from February 2015 to February 2019. All consecutive patients who underwent RA for severely calcified lesions were included in the study. The angiographic and procedural parameters and clinical outcomes were analyzed.

Results: A total of 115 patients with complex, severely calcified coronary lesions who underwent RA were included in the study. Out of which 88% were male and 12% were female. The mean age at presentation was 65.6 ± 7.7 years. Most patients (83.4%) underwent RA in Left Anterior Descending artery (LAD) followed by Right Coronary Artery (RCA) (12.2%), Left Circumflex Artery (LCX) (3.5%) and Left Main (LM) (0.9%). The average length of calcium and coronary artery calcium score were 27 ± 10 mm and 3.84 ± 0.77 respectively. Eleven (9.5%) patients underwent RA for in-stent restenosis. There were two (1.74%) in-stent thrombosis, two (1.74%) patients had perforation and one (0.87%) patient had dissection. The In-hospital MACE was 3.5% and MACE at 23 months follow up was 6.09%.

Conclusion: RA in complex, severely calcified coronary lesions can achieve very low complication and low out of hospital major adverse cardiac event rates even in high-risk patients. The study results convince us to sustain and even broaden the use of this novel, but under used, device in this era.