Comparison of the Efficacy and Safety of Orbital and Rotational Atherectomy in Calcified Narrowings in Patients Who Underwent Percutaneous Coronary Intervention.

Autor: Koifman E; Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia., Garcia-Garcia HM; Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia., Kuku KO; Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia., Kajita AH; Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia., Buchanan KD; Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia., Steinvil A; Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel., Rogers T; Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia; Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland., Bernardo NL; Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia., Lager R; Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia., Gallino RA; Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia., Ben-Dor I; Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia., Pichard AD; Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia., Torguson R; Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia., Gai J; Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia., Satler LF; Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia., Waksman R; Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia. Electronic address: ron.waksman@medstar.net.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2018 Apr 15; Vol. 121 (8), pp. 934-939. Date of Electronic Publication: 2018 Feb 13.
DOI: 10.1016/j.amjcard.2017.12.041
Abstrakt: We aimed to compare the safety and efficacy of rotational atherectomy (RA) and orbital atherectomy (OA) during percutaneous coronary intervention in an all-comer population with severely calcified lesions. We included all patients who underwent percutaneous coronary intervention with OA or RA in our institution from October 2013 until October 2016. Comparison of baseline and procedural characteristics, along with acute complication rates and postprocedural cardiac enzyme elevation, was performed. There were 191 RA and 57 OA patients. Other than creatinine clearance, which was lower in patients with OA (p = 0.01), there were no differences in baseline characteristics. OA was more frequent in left anterior descending artery lesions (p = 0.02), whereas RA was more common in right coronary artery lesions (p = 0.01). Intracoronary imaging rates were above 60% in both groups. There was a higher rate of coronary dissections with OA compared with RA (p = 0.003), but there was no difference in periprocedural events. Maximal troponin levels were similar in both groups. Residual stenosis measured by intravascular ultrasound in 29 patients revealed no significant differences between OA and RA (p = 0.58). In conclusion, RA and OA have similar safety and efficacy profiles in treating patients with calcified coronary lesions, and intracoronary imaging is highly beneficial in identifying coronary injury after atherectomy procedures.
(Copyright © 2018 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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