Rotablation in the treatment of high-risk patients with heavily calcified left-main coronary lesions

作     者：Meng-Hsiu Chiang Hung-Tao Yi Cheng-Rong Tsao Wei-Chun Chang Chieh-Shou Su Tsun-Jui Liu Kae-Woei Liang Chih-Tai Ting Wen-Lieng Lee 

作者机构：Division of Cardiology Saint Mary’s Hospital 160 Zhongzheng South Road Luodong Yilan 26546 Taiwan China Cardiovascular Center Taichung Veterans General Hospital 160 Sec.3 Chung-Kang Road Taichung 407 Taiwan China Institute of Clinical Medicine National Yang Ming University Schoo lof Medicine 155 Sec.2 Linong Street Taipei 112 Taiwan China 

出 版 物：《Journal of Geriatric Cardiology》 (老年心脏病学杂志（英文版）)

年 卷 期：2013年第10卷第3期

页      面：217-225页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

主　　题：Heavily calcified Left main coronary Rotational atherectomy 

摘      要：Objective Heavily calcified left-main coronary diseases (LMCA) remain a formidable challenge for percutaneous interventions (PCI). This study was to investigate the safety and efficacy of using rotational atherectomy (RA) in treating such lesions in actual practice. Methods From February 2004 to March 2012, all consecutive patients who received RA for heavily-calcified LMCA lesions in our cath lab were en-rolled. The relevant clinical and angiographic characteristics at the time of index PCI, as well as the clinical follow-up outcomes, were re-trieved and analyzed. Results A total of 34 consecutive patients were recruited with a mean age 77.2 ± 10.2 years. There were 82.4%pre-sented with acute coronary syndrome and 11.8%with cardiogenic shock. Chronic renal disease and diabetes were seen in 64.7%and 52.9%, respectively. Triple-vessel coronary disease was found in 76.5%of them. The mean SYNTAX score was 50 ± 15 and EuroSCORE II scale 5.6 ± 4.8. The angiographic success rate was 100%with a procedural success rate of 91.2%. The mean number of burrs per patient was 1.7 ± 0.5. Crossing-over stenting was used in 64.7%. Most stents were drug-eluting (67.6%). Intra-aortic ballon pump was used in 20.6%of the procedures. Three patients died during hospitalization, all due to presenting cardiogenic shock. No major complication occurred. Among 31 hospital survivors, the major adverse cardiac events (MACE) rate was 16.1%, all due to target lesion revascularization or target vessel revas-cularization. Conclusions In high-surgical-risk elderly patients, plaque modification with RA in PCI of heavily-calcified LMCA could be safely accomplished with a minimal complication rate and low out-of-hospital MACE.