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Quillot, Marine; Carrié, Didier; Lhermusier, Thibault; Bouisset, Frédéric; André, Romain; Elbaz, Meyer; Roncalli, Jérôme; Campelo-Parada, Francisco; Boudou, Nicolas

Short- and Mid-Term Prognosis of Patients Undergoing Rotational Atherectomy in Aortoostial Coronary Lesions in Left Main or Right Coronary Arteries

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  • Media type: E-Article
  • Title: Short- and Mid-Term Prognosis of Patients Undergoing Rotational Atherectomy in Aortoostial Coronary Lesions in Left Main or Right Coronary Arteries
  • Contributor: Quillot, Marine; Carrié, Didier; Lhermusier, Thibault; Bouisset, Frédéric; André, Romain; Elbaz, Meyer; Roncalli, Jérôme; Campelo-Parada, Francisco; Boudou, Nicolas
  • imprint: Hindawi Limited, 2019
  • Published in: Journal of Interventional Cardiology
  • Language: English
  • DOI: 10.1155/2019/9012787
  • ISSN: 0896-4327; 1540-8183
  • Keywords: Cardiology and Cardiovascular Medicine ; Radiology, Nuclear Medicine and imaging
  • Origination:
  • Footnote:
  • Description: <jats:p><jats:italic>Objective</jats:italic>. To determine short-term and mid-term prognosis in patients with calcified ostial coronary lesions who underwent rotational atherectomy (RA).<jats:italic> Background</jats:italic>. 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.<jats:italic> Methods</jats:italic>. 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.<jats:italic> Results</jats:italic>. The procedural success rate was high and similar in patients with and without ostial lesions (96.3%<jats:italic> vs</jats:italic> 94.7%, p=0.78), as was the rate of angiographic complications (7.5%<jats:italic> vs</jats:italic> 8.4%, p=0.80). However, the 30-day mortality rate was significantly higher in the aortoostial group (11.3%<jats:italic> vs</jats:italic> 4.8%, p=0.04), as was the 24-month rate of MACE (43.8%<jats:italic> vs</jats:italic> 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).<jats:italic> Conclusion</jats:italic>. 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.</jats:p>
  • Access State: Open Access