TY - JOUR
T1 - Rotational atherectomy in very long lesions
T2 - Results for the ROTATE registry
AU - Iannaccone, Mario
AU - Barbero, Umberto
AU - D'ascenzo, Fabrizio
AU - Latib, Azeem
AU - Pennacchi, Mauro
AU - Rossi, Marco Luciano
AU - Ugo, Fabrizio
AU - Meliga, Emanuele
AU - Kawamoto, Hiroyoshi
AU - Moretti, Claudio
AU - Ielasi, Alfonso
AU - Garbo, Roberto
AU - Colombo, Antonio
AU - Sardella, Gennaro
AU - Boccuzzi, Giacomo G.
N1 - Publisher Copyright:
© 2016 Wiley Periodicals, Inc.
PY - 2016/11/15
Y1 - 2016/11/15
N2 - Background: Rotational atherectomy (RA) is relatively contraindicated in patients with lesions ≥25 mm of length. Aim of this study was to evaluate RA safety and efficacy in this subset of patients with new technology and devices. Methods and Results: From April 2002 to August 2013, the ROTATE registry included all consecutive patients undergoing RA in 8 centres. They were divided into shorter lesion group (SLG, lesions < 25 mm) and longer lesion group (LLG, lesions ≥ 25 mm). The angiographic success (AS) was the primary end point. Procedural complications (PC), a composite end point of procedural perforation, slow flow/no flow, and in-hospital major acute cardiovascular events (MACE), were secondary end points, along with death, nonfatal MI, target lesion revascularization, and MACE during follow-up. Sensitivity analysis was performed according to generation of DES. 1186 patients were included: 51.5% in SLG and 48.4% in LLG. Mean age was 70.4 ± 9.3 years, 64.5% were male. AS and PC did not differ between the two groups (93% vs 91%, p = 0.24 and 9.8 vs 9.4%, p = 0.84). During follow-up (27.6 ± 22.9 months), MACE did not differ between the two groups (28% vs 29.1%, p = 0.95). At multivariate analysis chronic kidney disease, male gender increased risk of MACE (HR 1.94, IQR 1.29–2.0, p = 0.01, HR 0.52, IQR 0.34–0.79, p = 0.01) while second-generation DES seemed protective (HR 0.53, IQR 0.31–0.88, p = 0.02). Data were confirmed at sensitivity analysis for second-generation DES (759 pts, 63.9%). No differences were found in this subpopulation between the two groups in term of AS, PC, and long-term MACE (93.6% vs 93.5%, p = 0.28, 11.9% vs 9.4%, p = 0.32 and 25.5% vs 23.9%, p = 0.72, respectively). Conclusions: Treating coronary lesions ≥ 25 mm length with RA does not impact short- and long-term outcome, in particular, in patients with second-generation DES.
AB - Background: Rotational atherectomy (RA) is relatively contraindicated in patients with lesions ≥25 mm of length. Aim of this study was to evaluate RA safety and efficacy in this subset of patients with new technology and devices. Methods and Results: From April 2002 to August 2013, the ROTATE registry included all consecutive patients undergoing RA in 8 centres. They were divided into shorter lesion group (SLG, lesions < 25 mm) and longer lesion group (LLG, lesions ≥ 25 mm). The angiographic success (AS) was the primary end point. Procedural complications (PC), a composite end point of procedural perforation, slow flow/no flow, and in-hospital major acute cardiovascular events (MACE), were secondary end points, along with death, nonfatal MI, target lesion revascularization, and MACE during follow-up. Sensitivity analysis was performed according to generation of DES. 1186 patients were included: 51.5% in SLG and 48.4% in LLG. Mean age was 70.4 ± 9.3 years, 64.5% were male. AS and PC did not differ between the two groups (93% vs 91%, p = 0.24 and 9.8 vs 9.4%, p = 0.84). During follow-up (27.6 ± 22.9 months), MACE did not differ between the two groups (28% vs 29.1%, p = 0.95). At multivariate analysis chronic kidney disease, male gender increased risk of MACE (HR 1.94, IQR 1.29–2.0, p = 0.01, HR 0.52, IQR 0.34–0.79, p = 0.01) while second-generation DES seemed protective (HR 0.53, IQR 0.31–0.88, p = 0.02). Data were confirmed at sensitivity analysis for second-generation DES (759 pts, 63.9%). No differences were found in this subpopulation between the two groups in term of AS, PC, and long-term MACE (93.6% vs 93.5%, p = 0.28, 11.9% vs 9.4%, p = 0.32 and 25.5% vs 23.9%, p = 0.72, respectively). Conclusions: Treating coronary lesions ≥ 25 mm length with RA does not impact short- and long-term outcome, in particular, in patients with second-generation DES.
KW - calcific lesion
KW - rotablator
KW - rotational atherectomy
KW - second-generation DES
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U2 - 10.1002/ccd.26548
DO - 10.1002/ccd.26548
M3 - Article
C2 - 27083771
AN - SCOPUS:84963576433
SN - 1522-1946
VL - 88
SP - E164-E172
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 6
ER -