Efficacy of intravascular ultrasound guided rotational atherectomy for heavily calcified coronary lesions
10.3760/cma.j.issn.0253-3758.2014.07.005
- VernacularTitle:血管内超声指导下冠状动脉严重钙化病变旋磨治疗的有效性
- Author:
Yong SUN
1
;
Jun JIANG
;
Guozhong ZHU
;
Changling LI
;
Liang DONG
;
Xianbao LIU
;
Liang LYU
;
Xinyang HU
;
Meixiang XIANG
;
Jian′an WANG
Author Information
1. 浙江大学医学院附属第二医院心内科
- Keywords:
Coronary disease;
Calcinosis;
Ultrasonography,interventional
- From:
Chinese Journal of Cardiology
2014;(7):545-550
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy of intravascular ultrasound guided tranradial rotational atherectomy ( RA) followed by drug eluting stent ( DES) implantation in treating patients with heavily calcified coronary lesions.Methods Clinical characteristics , coronary angiogram , intravascular ultrasound images , peri-procedure and follow-up data ( including death , myocardial infarction and target lesion revascularization ) of 44 patients treated with RA and DES implantation under the guidance of IVUS in our department from March 2011 to March 2013 were retrospectively analyzed.IVUS examination was carried out before RA , after RA and stent implantation to guide whether further RA or post dilatation was needed.According to the arc of calcification , the patients were divided into group A (90°-270°,18 cases) and group B (271°-360°,26 cases).Results In A and B group, the arc of calcification was (195 ±71)°in group A and (345 ±23)°in group B(P<0.01), length of calcification was (34.4 ±11.8)mm in group A and (20.0 ±6.6) mm in group B ( P<0.05).Number of burrs used and size of largest burr used were similar between 2 groups (both P>0.05).Acute cross sectional area gain after RA was (0.43 ±0.32)mm2 in group A and (0.53 ±0.38)mm2 in group B (P>0.05).After RA, there was significant decrease in the arc of calcification in group B compared with baseline ( ( 324 ±52 ) °vs.( 345 ±23 ) °, P <0.05 ).The minimal lumen area and diameter were significantly increased after RA resulting in significant decrease in the plaque burden in both groups ( all P<0.05 ).The final minimal lumen area after stenting were similar between 2 groups (P>0.05).Procedure success rate was 100%(44/44) without any major complications such as death , acute myocardial infarction and coronary perforation.During the ( 16.6 ±6.3 ) months follow-up, there was 1 death in group A , 1 target lesion revascularization in group B and there was no acute myocardial infarction in the 2 groups.Conclusion Heavily calcified coronary lesions can be effectively and safely treated by transradial RA under the guidance of IVUS.
