Procedural and 1-year clinical outcomes of orbital atherectomy for treatment of coronary in-stent restenosis: A single-center, retrospective study
| Autor: | Vishal Kapur, Nitin Barman, Artiom Petrov, Roxana Mehran, Samin K. Sharma, Yuliya Vengrenyuk, Annapoorna Kini, Benjamin Benhuri, Usman Baber, Gregg W. Stone, Javed Suleman, Keisuke Yasumura, Joseph Sweeny |
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| Rok vydání: | 2020 |
| Předmět: |
Atherectomy
Coronary medicine.medical_specialty Atherectomy medicine.medical_treatment 030204 cardiovascular system & hematology Coronary Angiography Coronary Restenosis 03 medical and health sciences 0302 clinical medicine Percutaneous Coronary Intervention Restenosis Angioplasty medicine Humans Radiology Nuclear Medicine and imaging 030212 general & internal medicine Myocardial infarction Retrospective Studies business.industry Percutaneous coronary intervention General Medicine Debulking medicine.disease Surgery Treatment Outcome Conventional PCI Stents Cardiology and Cardiovascular Medicine business Mace |
| Zdroj: | Catheterization and cardiovascular interventions : official journal of the Society for Cardiac AngiographyInterventionsREFERENCES. 97(3) |
| ISSN: | 1522-726X |
| Popis: | Objectives We evaluated the procedural and 1-year clinical outcomes of orbital atherectomy (OA) for treatment of coronary in-stent restenosis (ISR). Background The optimal treatment for ISR remains uncertain. While rotational and laser atherectomy have been used as neointimal debulking techniques for ISR, there have been few reports on OA for ISR. Methods This is a retrospective observational study of consecutive patients who underwent percutaneous coronary intervention (PCI) for ISR with OA in Mount Sinai catheterization laboratory between November 2013 and January 2018. Procedural success was defined as angiographic success without in-hospital major adverse cardiac events (MACE; the composite of all-cause death, myocardial infarction [MI], or target vessel revascularization). Clinical outcomes were assessed at 1 month and 12 months postprocedure. Results A total of 87 patients were included in the study. All 87 patients were treated with OA, after which 49 (56.3%) patients also received new drug-eluting stents. Angiographic success was achieved in 87 (100%) patients and procedural success was achieved in 79 (90.8%) patients. In-hospital MACE occurred in 8 (9.2%) patients, all due to periprocedural non-Q-wave MI. Acute lumen gain was 1.19 ± 0.57 mm after OA plus balloon angioplasty and 1.75 ± 0.50 mm after stent placement. MACE within 1 year occurred in 17 (19.5%) patients. Conclusions OA for ISR was performed with favorable procedural and 1-year clinical outcomes. Randomized trials are warranted to determine whether OA improves the poor prognosis of patients with ISR treated without debulking. |
| Databáze: | OpenAIRE |
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