Safety and efficacy of rotational atherectomy in the interventional treatment of coronary chronic total occlusion lesions
10.3760/cma.j.issn.0253-3758.2018.04.005
- VernacularTitle: 冠状动脉内旋磨术在慢性完全闭塞病变介入治疗中应用的安全性和有效性
- Author:
Jianying MA
1
;
Junjie GUO
;
Lei HOU
;
Feng ZHANG
;
Kang YAO
;
Dong HUANG
;
Hao LU
;
Yuxiang DAI
;
Chenguang LI
;
Shufu CHANG
;
Qing QIN
;
Lei GE
;
Juying QIAN
;
Junbo GE
Author Information
1. Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Disease, Shanghai 200032, China
- Publication Type:Journal Article
- Keywords:
Coronary artery disease;
Treatment outcome;
Rotational atherectomy
- From:
Chinese Journal of Cardiology
2018;46(4):274-278
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the safety and efficacy of rotational atherectomy in the interventional treatment of coronary chronic total occlusion lesions.
Methods:In this retrospective study,a total of 31 consecutive patients with coronary chronic total occlusion(CTO) lesions underwent rotational atherectomy in our hospital from February 2004 to December 2016 were enrolled,and the clinical features were analyzed. Coronary atherectomy was performed if balloon failed to cross the CTO lesions or balloon could not be fully dilated in the CTO lesions after wire crossing. The definition of procedure success was defined as residual stenosis less than 20% after implantation of drug eluting stent and rotational atherectomy. After the procedure, the patients were followed up to observe major adverse cardiac and cerebral vascular events which including cardiogenic death, myocardial infarction, cerebrovascular accident, and target lesion revascularization.
Results:The 1.25 mm diameter burr was firstly selected in 80.6% (25/31) patients,and 96.8%(30/31) patients used only 1 burr to complete the rotational atherectomy procedure. The complication rate was 9.8% (3/31) including 1 patient with coronary dissection and 3 patients with slow flow or no flow. There was 1 patent with both coronary dissection and slow flow. The procedure success rate was 96.8%(30/31). Interventional treatment related myocardial infarction occurred in 3 patients during hospitalization.The 30 patients with procedure success were followed up 36(11, 96) months. The incidence rate of major adverse cardiac and cerebral vascular events was 13.3% (4/30), of which the cardiogenic death rate was 3.3% (1/30), the myocardial infarction rate was 6.7% (2/30), cerebrovascular accident rate was 3.3%(1/30),and the target lesion revascularization rate was 6.7% (2/30).
Conclusion:Rotational atherectomy is safe and effective in the interventional treatment of coronary CTO lesions.
