The University of Southampton
University of Southampton Institutional Repository

Comparison of rotational atherectomy, plain old balloon angioplasty, and cutting-balloon angioplasty prior to drug-eluting stent implantation for the treatment of heavily calcified coronary lesions

Comparison of rotational atherectomy, plain old balloon angioplasty, and cutting-balloon angioplasty prior to drug-eluting stent implantation for the treatment of heavily calcified coronary lesions
Comparison of rotational atherectomy, plain old balloon angioplasty, and cutting-balloon angioplasty prior to drug-eluting stent implantation for the treatment of heavily calcified coronary lesions
BACKGROUND: The optimal technique for lesion preparation in heavily calcified coronary lesions (HCCL) prior to drug-eluting stent (DES) implantation has not been described. The aim of this study was to compare the clinical outcomes of lesion preparation with rotational atherectomy (ROTA), plain old balloon angioplasty (POBA), or cutting-balloon angioplasty (CBA) in patients with HCCL who were treated with DES.

METHODS: The study cohort comprised 737 consecutive patients (874 lesions) who underwent RA (n = 264), POBA (n = 220), or CBA (n = 253) for HCCL at our institution and were treated with DES. Patients with mild or moderate calcified lesions, restenotic lesions, treatment with bare-metal stent (BMS), or history of prior coronary artery bypass graft (CABG) were excluded. The analyzed clinical parameters were the 1-month, 6-month, and 12-month rates of death (all-cause and cardiac), Q-wave myocardial infarction (MI), target-lesion revascularization (TLR), definite stent thrombosis (ST), and major adverse cardiac event (MACE), defined as the composite of death, Q-wave MI, or TLR.

RESULTS: The patients were well matched for their baseline characteristics except for age (RA = 71.9 ± 10.4 years; POBA = 68.0 ± 10.8 years; CBA = 68.7 ± 11.8 years; P<.001) and hypertension (RA = 90.9%; POBA = 80.9%; CBA = 84.2%; P=.01), which were different among the three cohorts. The three cohorts had similar clinical outcomes at both short-term and long-term follow-up. The 12-month results were all-cause death (RA = 9.8%; POBA = 8.2%; CBA = 4.5%; P=.18), cardiac death (RA = 3.1%; POBA = 2.5%; CBA = 1.3%; P=.61), Q-wave MI (RA = 0%; POBA = 0%; CBA = 0.7%; P>.99), TLR (RA = 5.2%; POBA = 3.5%; CBA = 3.9%; P=.76), ST (RA = 0%; POBA = 0%; CBA = 0.6%; P=.63) and MACE (RA = 14.6%; POBA = 12.3%; CBA = 8.3%; P=.20). The 1-year MACE-free survival rates were also similar among the three cohorts (log-rank P=.20).

CONCLUSION: A strategy of lesion preparation with RA, POBA, or CBA in HCCL may be associated with similar clinical outcomes in patients undergoing percutaneous intervention with DES. The RA group had a trend toward greater MACE, death, and TLR.
1042-3931
387-391
Tian, Wenjie
5e207a99-08bf-44a8-adea-a881a2655405
Mahmoudi, Michael
f6a55246-399e-4f81-944e-a4b169786e8a
Lhermusier, Thibault
72d82944-6aa5-4ef7-b7e4-ab31eec6bfcd
Kiramijyan, Sarkis
ac47a82a-0e72-459e-a69a-8deb4989b999
Ota, Hideaki
14f81e1f-4ac6-451e-9d72-13b48099298a
Chen, Fang
c1c61717-ce9b-43d8-9604-d09a72f8a510
Torguson, Rebecca
2fc1ca2f-5f09-47bc-8749-4297680de611
Suddath, William O.
0768302d-bb8c-4522-8986-7364b4d41ad2
Satler, Lowell F.
ca752a0b-53b4-4107-a30b-a7b42167112a
Pichard, Augusto D.
d2f75f00-aca0-4897-8758-08d0b2e57beb
Waksman, Ron
23d6bf65-0556-4930-8fad-224a559b34e0
Tian, Wenjie
5e207a99-08bf-44a8-adea-a881a2655405
Mahmoudi, Michael
f6a55246-399e-4f81-944e-a4b169786e8a
Lhermusier, Thibault
72d82944-6aa5-4ef7-b7e4-ab31eec6bfcd
Kiramijyan, Sarkis
ac47a82a-0e72-459e-a69a-8deb4989b999
Ota, Hideaki
14f81e1f-4ac6-451e-9d72-13b48099298a
Chen, Fang
c1c61717-ce9b-43d8-9604-d09a72f8a510
Torguson, Rebecca
2fc1ca2f-5f09-47bc-8749-4297680de611
Suddath, William O.
0768302d-bb8c-4522-8986-7364b4d41ad2
Satler, Lowell F.
ca752a0b-53b4-4107-a30b-a7b42167112a
Pichard, Augusto D.
d2f75f00-aca0-4897-8758-08d0b2e57beb
Waksman, Ron
23d6bf65-0556-4930-8fad-224a559b34e0

Tian, Wenjie, Mahmoudi, Michael, Lhermusier, Thibault, Kiramijyan, Sarkis, Ota, Hideaki, Chen, Fang, Torguson, Rebecca, Suddath, William O., Satler, Lowell F., Pichard, Augusto D. and Waksman, Ron (2015) Comparison of rotational atherectomy, plain old balloon angioplasty, and cutting-balloon angioplasty prior to drug-eluting stent implantation for the treatment of heavily calcified coronary lesions. Journal of Invasive Cardiology, 27 (9), 387-391. (PMID:26332873)

Record type: Article

Abstract

BACKGROUND: The optimal technique for lesion preparation in heavily calcified coronary lesions (HCCL) prior to drug-eluting stent (DES) implantation has not been described. The aim of this study was to compare the clinical outcomes of lesion preparation with rotational atherectomy (ROTA), plain old balloon angioplasty (POBA), or cutting-balloon angioplasty (CBA) in patients with HCCL who were treated with DES.

METHODS: The study cohort comprised 737 consecutive patients (874 lesions) who underwent RA (n = 264), POBA (n = 220), or CBA (n = 253) for HCCL at our institution and were treated with DES. Patients with mild or moderate calcified lesions, restenotic lesions, treatment with bare-metal stent (BMS), or history of prior coronary artery bypass graft (CABG) were excluded. The analyzed clinical parameters were the 1-month, 6-month, and 12-month rates of death (all-cause and cardiac), Q-wave myocardial infarction (MI), target-lesion revascularization (TLR), definite stent thrombosis (ST), and major adverse cardiac event (MACE), defined as the composite of death, Q-wave MI, or TLR.

RESULTS: The patients were well matched for their baseline characteristics except for age (RA = 71.9 ± 10.4 years; POBA = 68.0 ± 10.8 years; CBA = 68.7 ± 11.8 years; P<.001) and hypertension (RA = 90.9%; POBA = 80.9%; CBA = 84.2%; P=.01), which were different among the three cohorts. The three cohorts had similar clinical outcomes at both short-term and long-term follow-up. The 12-month results were all-cause death (RA = 9.8%; POBA = 8.2%; CBA = 4.5%; P=.18), cardiac death (RA = 3.1%; POBA = 2.5%; CBA = 1.3%; P=.61), Q-wave MI (RA = 0%; POBA = 0%; CBA = 0.7%; P>.99), TLR (RA = 5.2%; POBA = 3.5%; CBA = 3.9%; P=.76), ST (RA = 0%; POBA = 0%; CBA = 0.6%; P=.63) and MACE (RA = 14.6%; POBA = 12.3%; CBA = 8.3%; P=.20). The 1-year MACE-free survival rates were also similar among the three cohorts (log-rank P=.20).

CONCLUSION: A strategy of lesion preparation with RA, POBA, or CBA in HCCL may be associated with similar clinical outcomes in patients undergoing percutaneous intervention with DES. The RA group had a trend toward greater MACE, death, and TLR.

Text
wm 387-390 Tian Sept JIC 2015 - Version of Record
Restricted to Repository staff only
Request a copy

More information

Accepted/In Press date: 23 April 2015
Published date: September 2015
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 394525
URI: http://eprints.soton.ac.uk/id/eprint/394525
ISSN: 1042-3931
PURE UUID: e7658b42-bf04-4e42-8fff-0fd1c82ca8ff
ORCID for Michael Mahmoudi: ORCID iD orcid.org/0000-0003-1293-8461

Catalogue record

Date deposited: 20 May 2016 08:31
Last modified: 28 Apr 2022 02:14

Export record

Contributors

Author: Wenjie Tian
Author: Thibault Lhermusier
Author: Sarkis Kiramijyan
Author: Hideaki Ota
Author: Fang Chen
Author: Rebecca Torguson
Author: William O. Suddath
Author: Lowell F. Satler
Author: Augusto D. Pichard
Author: Ron Waksman

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×