Safety and feasibility of rotational atherectomy (RA) versus conventional stenting in patients with chronic total occlusion (CTO) lesions: a systematic review and meta-analysis.

Autor: Abdelaziz A; Medical Research group of Egypt (MRGE), Cairo, Egypt.; Faculty of Medicine, Al-Azhar University, Cairo, Egypt., Elsayed H; Medical Research group of Egypt (MRGE), Cairo, Egypt. hanaa.elsayed525@gmail.com.; Faculty of Medicine, Zagazig University, Zagazig, Egypt. hanaa.elsayed525@gmail.com., Hamdaalah A; Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt., Atta K; Medical Research group of Egypt (MRGE), Cairo, Egypt.; Institute of Medicine, National Research Mordovia State University, Saransk, Russia., Mechi A; Internal Medicine Department, Medicine College, University of Kufa, Najaf, Iraq., Kadhim H; College of Medicine, Al Muthanna university, Samawah, Iraq., Aboutaleb AM; Medical Research group of Egypt (MRGE), Cairo, Egypt.; Faculty of Medicine, Zagazig University, Zagazig, Egypt., Elaraby A; Medical Research group of Egypt (MRGE), Cairo, Egypt.; Faculty of Medicine, Al-Azhar University, Cairo, Egypt., Ellabban MH; Medical Research group of Egypt (MRGE), Cairo, Egypt.; Faculty of Medicine, Al-Azhar University, Cairo, Egypt., Rzk FM; Medical Research group of Egypt (MRGE), Cairo, Egypt.; Faculty of Medicine, Menoufia University, Menoufia, Egypt., Eid M; Medical Research group of Egypt (MRGE), Cairo, Egypt.; Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt., AboElfarh HE; Medical Research group of Egypt (MRGE), Cairo, Egypt.; Neurology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt., Ibrahim RA; Medical Research group of Egypt (MRGE), Cairo, Egypt.; Faculty of Medicine, Kafr Elsheikh University, Kafr Elsheikh, Egypt., Zawaneh EA; Medical Research group of Egypt (MRGE), Cairo, Egypt.; Faculty of medicine, Jordan university of science and technology, Irbid, Jordan., Ezzat M; Medical Research group of Egypt (MRGE), Cairo, Egypt.; Faculty of Medicine, Menoufia University, Menoufia, Egypt., Abdelaziz M; Medical Research group of Egypt (MRGE), Cairo, Egypt.; Faculty of Medicine, Al-Azhar University, Cairo, Egypt., Hafez AH; Medical Research group of Egypt (MRGE), Cairo, Egypt.; Faculty of Medicine, Al-Azhar University, Cairo, Egypt., Fadel S; Medical Research group of Egypt (MRGE), Cairo, Egypt.; Faculty of Medicine, Suez Canal University, Ismailia, Egypt., Ghaith HS; Medical Research group of Egypt (MRGE), Cairo, Egypt.; Faculty of Medicine, Al-Azhar University, Cairo, Egypt., Suppah M; Department of Cardiovascular Medicine, Mayo Clinic, 13400 E Shea Boulevard, Scottsdale, AZ, 85259, USA.
Jazyk: angličtina
Zdroj: BMC cardiovascular disorders [BMC Cardiovasc Disord] 2024 Jan 02; Vol. 24 (1), pp. 4. Date of Electronic Publication: 2024 Jan 02.
DOI: 10.1186/s12872-023-03673-2
Abstrakt: Background and Aim: Interventional cardiologists face challenges in managing chronic total occlusion (CTO) lesions, with conflicting results when comparing rotational atherectomy (RA) to conventional PCI. This meta-analysis aims to provide a critical evaluation of the safety and feasibility of RA in CTO lesions.
Methods: PubMed, Scopus, Web of Science, Ovid, and Cochrane central library until April 2023 were searched for relevant studies. MACE was our primary outcomes, other outcomes were all cause of death, cardiac death, MI, and TVR. Also, we reported angiographic outcomes as technical success, procedural success, and procedural complications in a random effect model. The pooled data was analyzed using odds ratio (OR) with its 95% CI using STATA 17 MP.
Results: Seven studies comprising 5494 patients with a mean follow-up of 43.1 months were included in this meta-analysis. Our pooled analysis showed that RA was comparable to PCI to decrease the incidence of MACE (OR = 0.98, 95% CI [0.74 to 1.3], p = 0.9). Moreover, there was no significant difference between RA and conventional PCI in terms of other clinical or angiographic outcomes.
Conclusion: Our study showed that RA had comparable clinical and angiographic outcomes as conventional PCI in CTO lesions, which offer interventional cardiologists an expanded perspective when addressing calcified lesions.
Prospero Registration: CRD42023417362.
(© 2023. The Author(s).)
Databáze: MEDLINE
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