Short- and Mid-Term Prognosis of Patients Undergoing Rotational Atherectomy in Aortoostial Coronary Lesions in Left Main or Right Coronary Arteries
Objective. To determine short-term and mid-term prognosis in patients with calcified ostial coronary lesions who underwent rotational atherectomy (RA). Background. RA was developed to facilitate stenting in complex lesions. Treatment of calcified aortoostial coronary lesions with RA appears to have...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Journal of Interventional Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2019/9012787 |
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| author | Marine Quillot Didier Carrié Thibault Lhermusier Frédéric Bouisset Romain André Meyer Elbaz Jérôme Roncalli Francisco Campelo-Parada Nicolas Boudou |
| author_facet | Marine Quillot Didier Carrié Thibault Lhermusier Frédéric Bouisset Romain André Meyer Elbaz Jérôme Roncalli Francisco Campelo-Parada Nicolas Boudou |
| author_sort | Marine Quillot |
| collection | DOAJ |
| description | Objective. To determine short-term and mid-term prognosis in patients with calcified ostial coronary lesions who underwent rotational atherectomy (RA). Background. RA was developed to facilitate stenting in complex lesions. Treatment of calcified aortoostial coronary lesions with RA appears to have poorer procedure outcomes than nonostial lesions; yet the literature on this topic is scarce. Methods. Of 498 consecutive patients who underwent RA, a total of 80 (16.1%) presented with aortoostial lesions. A comparative, monocentric study was performed between patients with aortoostial and nonaortoostial stenosis, in a retrospective registry. The primary endpoint was the procedural success rate. Secondary endpoints were the rates of major adverse cardiac and cardiovascular events (MACE) at 30 days and 24 months. Results. The procedural success rate was high and similar in patients with and without ostial lesions (96.3% vs 94.7%, p=0.78), as was the rate of angiographic complications (7.5% vs 8.4%, p=0.80). However, the 30-day mortality rate was significantly higher in the aortoostial group (11.3% vs 4.8%, p=0.04), as was the 24-month rate of MACE (43.8% vs 31.8%, p=0.04). The aortoostial location of the lesion was an independent factor associated with the occurrence of cardiovascular events at 24 months (HR = 1.52, 95% CI, 1.03-2.26, p=0.035). Conclusion. Procedural success and complication rates were similar in patients with and without aortoostial lesions. Despite a poor short- and mid-term prognosis, rotational atherectomy appears to be a feasible and safe treatment option for calcified aortoostial coronary lesions. |
| format | Article |
| id | doaj-art-2851fbc267a749e1803ea00fefcef29e |
| institution | OA Journals |
| issn | 0896-4327 1540-8183 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Interventional Cardiology |
| spelling | doaj-art-2851fbc267a749e1803ea00fefcef29e2025-08-20T02:04:18ZengWileyJournal of Interventional Cardiology0896-43271540-81832019-01-01201910.1155/2019/90127879012787Short- and Mid-Term Prognosis of Patients Undergoing Rotational Atherectomy in Aortoostial Coronary Lesions in Left Main or Right Coronary ArteriesMarine Quillot0Didier Carrié1Thibault Lhermusier2Frédéric Bouisset3Romain André4Meyer Elbaz5Jérôme Roncalli6Francisco Campelo-Parada7Nicolas Boudou8Cardiology Department, University Hospital of Toulouse, Toulouse, FranceCardiology Department, University Hospital of Toulouse, Toulouse, FranceCardiology Department, University Hospital of Toulouse, Toulouse, FranceCardiology Department, University Hospital of Toulouse, Toulouse, FranceCardiology Department, University Hospital of Toulouse, Toulouse, FranceCardiology Department, University Hospital of Toulouse, Toulouse, FranceCardiology Department, University Hospital of Toulouse, Toulouse, FranceCardiology Department, University Hospital of Toulouse, Toulouse, FranceCardiology Department, University Hospital of Toulouse, Toulouse, FranceObjective. To determine short-term and mid-term prognosis in patients with calcified ostial coronary lesions who underwent rotational atherectomy (RA). Background. RA was developed to facilitate stenting in complex lesions. Treatment of calcified aortoostial coronary lesions with RA appears to have poorer procedure outcomes than nonostial lesions; yet the literature on this topic is scarce. Methods. Of 498 consecutive patients who underwent RA, a total of 80 (16.1%) presented with aortoostial lesions. A comparative, monocentric study was performed between patients with aortoostial and nonaortoostial stenosis, in a retrospective registry. The primary endpoint was the procedural success rate. Secondary endpoints were the rates of major adverse cardiac and cardiovascular events (MACE) at 30 days and 24 months. Results. The procedural success rate was high and similar in patients with and without ostial lesions (96.3% vs 94.7%, p=0.78), as was the rate of angiographic complications (7.5% vs 8.4%, p=0.80). However, the 30-day mortality rate was significantly higher in the aortoostial group (11.3% vs 4.8%, p=0.04), as was the 24-month rate of MACE (43.8% vs 31.8%, p=0.04). The aortoostial location of the lesion was an independent factor associated with the occurrence of cardiovascular events at 24 months (HR = 1.52, 95% CI, 1.03-2.26, p=0.035). Conclusion. Procedural success and complication rates were similar in patients with and without aortoostial lesions. Despite a poor short- and mid-term prognosis, rotational atherectomy appears to be a feasible and safe treatment option for calcified aortoostial coronary lesions.http://dx.doi.org/10.1155/2019/9012787 |
| spellingShingle | Marine Quillot Didier Carrié Thibault Lhermusier Frédéric Bouisset Romain André Meyer Elbaz Jérôme Roncalli Francisco Campelo-Parada Nicolas Boudou Short- and Mid-Term Prognosis of Patients Undergoing Rotational Atherectomy in Aortoostial Coronary Lesions in Left Main or Right Coronary Arteries Journal of Interventional Cardiology |
| title | Short- and Mid-Term Prognosis of Patients Undergoing Rotational Atherectomy in Aortoostial Coronary Lesions in Left Main or Right Coronary Arteries |
| title_full | Short- and Mid-Term Prognosis of Patients Undergoing Rotational Atherectomy in Aortoostial Coronary Lesions in Left Main or Right Coronary Arteries |
| title_fullStr | Short- and Mid-Term Prognosis of Patients Undergoing Rotational Atherectomy in Aortoostial Coronary Lesions in Left Main or Right Coronary Arteries |
| title_full_unstemmed | Short- and Mid-Term Prognosis of Patients Undergoing Rotational Atherectomy in Aortoostial Coronary Lesions in Left Main or Right Coronary Arteries |
| title_short | Short- and Mid-Term Prognosis of Patients Undergoing Rotational Atherectomy in Aortoostial Coronary Lesions in Left Main or Right Coronary Arteries |
| title_sort | short and mid term prognosis of patients undergoing rotational atherectomy in aortoostial coronary lesions in left main or right coronary arteries |
| url | http://dx.doi.org/10.1155/2019/9012787 |
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