Safety Analysis of Coronary Artery Stent Rotational Atherectomy
10.3969/j.issn.1000-3614.2024.07.003
- VernacularTitle:冠状动脉支架内旋磨术的安全性分析
- Author:
Junshan LI
1
;
Li YU
;
Yaoming SONG
;
Jianying MA
;
Bo LUAN
;
Mingduo ZHANG
;
Yong DONG
;
Jingjing RONG
;
Hongwei PAN
;
Changlu WANG
Author Information
1. 湖南省人民医院(湖南师范大学附属第一医院)湖南省心力衰竭临床医学研究中心 心血管内科,长沙 410005
- Keywords:
coronary heart disease;
coronary artery stent;
rotarional atherectomy;
safety
- From:
Chinese Circulation Journal
2024;39(7):669-675
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To analyze the safety of coronary artery stent rotational atherectomy due to stent underexpansion,in-stent restenosis,stent deformation,stent damage,and guide wire entrapment. Methods:A total of 19 patients with coronary artery disease who underwent coronary artery stent rotational atherectomy for the above reasons in 7 large heart centers in China from 2016 to 2022 were collected.Their baseline data,procedure process data,procedural complications,the occurrence of procedure-related adverse events(type 4a myocardial infarction,emergency coronary artery bypass grafting,and all-cause death)during hospitalization and major adverse cardiovascular events(MACE,including target vessel revascularization,stroke,all-cause death,and recurrent myocardial infarction)during post-discharge follow-up were retrospectively collected. Results:The mean age of the 19 patients was 70(64,73)years,and 13 patients were males.The mean left ventricular ejection fraction was(56.89±8.76)%.Radial artery approach was used in 13 patients,11 patients used 1 burr during the intervention period,6 patients used 2 burrs,and 2 patients used 3 burrs.The average times of burr passing through the lesion was(7.00±4.23)times.The surgical success rate was 100%,and the immediate lumen acquired area was(1.23±0.78)mm2.Drug-eluting stents were successfully implanted in all patients after spinning.Coronary slow blood flow occurred in 1 case after rotational grinding,which was improved after drug treatment.The burr was entrapmented in 3 cases and successfully pulled out after operation.No coronary artery perforation,coronary artery dissection,coronary artery spasm,emergency thoracotomy,or death occurred during the operation,and no procedure-related adverse events occurred during hospitalization.During 3 to 24 months of follow-up,1 patient underwent target vessel revascularization,and there were no MACE in other patients. Conclusions:Coronary artery stent rotational atherectomy in patients with stent underexpansion,in-stent restenosis,stent deformation,stent damage,and guide wire entrapment,is a feasible option,with a high surgical success rate and satisfactory safety.None of the patients experienced MACE during long-term follow-up.
