Rotational Atherectomy Complicated by Coronary Perforation Is Associated With Poor Outcomes: Analysis of 10,980 Cases From the British Cardiovascular Intervention Society Database
| Autor: | Sara Al‐Raisi, Andrew S P Sharp, Majd B. Protty, Richard Anderson, Vasim Farooq, Tim Kinnaird, Omar Aldalati, Hussain I. Hussain, Sean Gallagher |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Atherectomy
Coronary Databases Factual Heart block medicine.medical_treatment Perforation (oil well) Coronary Artery Disease 030204 cardiovascular system & hematology computer.software_genre Cardioversion 03 medical and health sciences Percutaneous Coronary Intervention 0302 clinical medicine Risk Factors medicine Humans Hospital Mortality 030212 general & internal medicine Retrospective Studies Database business.industry Incidence (epidemiology) Percutaneous coronary intervention General Medicine Bleed medicine.disease Stenosis Treatment Outcome Heart Injuries Conventional PCI Female Cardiology and Cardiovascular Medicine business computer |
| Zdroj: | Cardiovascular Revascularization Medicine. 28:9-13 |
| ISSN: | 1553-8389 |
| Popis: | Background Rotational atherectomy (RA) during PCI is linked to a higher likelihood coronary perforations (CP). However, the evidence base on incidence, predictors and outcomes of this complication in RA-PCI remains limited. Methods Using the British Cardiac Intervention Society database, data were analysed on all RA-PCI procedures in UK 2007–2014. Descriptive statistics and multivariate logistic regressions were used to examine baseline, procedural and outcome associations. Results During 10,980 RA-PCI procedures, 167 CPs were recorded (1.52%) with a stable annual incidence. Baseline and procedural covariates associated with higher rates of RA perforation were number of stents used, female gender, smoking, and left-main stenosis. CP was significantly associated with shock, DC cardioversion, heart block, transfusion, emergency surgery, periprocedural MI, in-hospital major bleed, acute kidney injury, dissection, side branch loss and in-hospital death. CP was also associated with higher rates of in-hospital MACCE (OR 12.22, 95% CI 7.67–19.47), 30-day mortality (OR 10.02, 95% CI 5.87–17.09) and 12-month mortality (OR 3.90, 95% CI 2.53–6.02). Conclusions CP is more frequent in RA-PCI than all-comer PCI and is associated with a significant burden of morbidity and mortality. There are a limited number of baseline and procedural co-variates associated with CP in RA-PCI, making it difficult to predict. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect