Direct Versus Pre-dilated Rotational Atherectomy for Treating Calcified Coronary Lesions
10.3969/j.issn.1000-3614.2016.04.004
- VernacularTitle:直接旋磨和球囊预扩旋磨治疗冠状动脉钙化病变的对比研究
- Author:
Ting SUN
;
Jing BAI
;
Yu WANG
;
Shaoping SU
;
Ran ZHANG
;
Xia YANG
;
Ya HUANG
;
Liang PENG
;
Zhe TANG
;
Wenbin SHEN
;
Jingguo NONG
- Publication Type:Journal Article
- Keywords:
Coronary artery,rotational atherectomy;
Calciifcaifon,physiological;
Ultrasounograply,interventional
- From:
Chinese Circulation Journal
2016;31(4):327-331
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To compare the efifcacy of direct and pre-dilated atherectomy (RA) for treating the patients with calciifed coronary lesions. Methods: A total of 137 coronary artery disease (CAD) patients received RA treatment in our hospital from 2010-04 to 2014-09 were retrospectively studied. The ischemic related lesions were all deifned as calciifed coronary lesions. The patients were divided into 2 groups: Direct RA group,n=81 and Pre-dilated RA group, the patients received balloon dilatation followed by RA,n=56. The procedural features, complications, in-hospital and 1 year occurrence rates of major cardiaccerebral vascular events (MACCE) were compared between 2 groups. Results: Compared with Pre-dilated RA group, Direct RA group had the less pre-stent balloon application,P=0.000 and the higher maximum post-dilatationpressure,P=0.004; lower rate of in-operative complication (14.8% vs 32.1%),P=0.016; higher rate of acute lumen gain (128.52±75.77) % vs (77.12±27.01) %,P=0.004; lower MACCE occurrencerate(7.3% vs 23.6%) at 1 year period,P=0.006.Cox regression analysis presented that the following indexes were related to MACCE occurrence within 1 year of RA treatment: balloon dilatation before RA (HR=8.166, 95% CI 1.872-35.614,P=0.005), left main disease (HR=13.649, 95% CI 2.983-62.440,P=0.001), minimum post-operative lumen area (HR=0.583, 95% CI 0.378-0.879,P=0.010), post-dilatation (HR=0.066, 95% CI 0.013-0.332,P=0.001) and EF>40% (HR=0.019, 95% CI 0.002-0.158, P=0.000). Conclusion: Direct RA had the lower MACCE occurrence rate at 1 year period, this might be related to less operative complication and the optimal lumen gain.
