Authors

• Boris Starčević — Klinička bolnica Dubrava, Zagreb, Hrvatska — ORCID: 0000-0002-3090-2772
• Petra Vitlov — Klinička bolnica Dubrava, Zagreb, Hrvatska — ORCID: 0000-0001-6983-1409
• Ante Lisičić — Klinička bolnica Dubrava, Zagreb, Hrvatska — ORCID: 0000-0002-4365-9652
• Ognjen Čančarević — Klinička bolnica Dubrava, Zagreb, Hrvatska — ORCID: 0000-0002-1285-8042
• Irzal Hadžibegović — Klinička bolnica Dubrava, Zagreb, Hrvatska — ORCID: 0000-0001-9139-5009
• Aleksandar Blivajs — Klinička bolnica Dubrava, Zagreb, Hrvatska — ORCID: 0000-0003-3404-3837

Abstract

**Introduction:** Rotational atherectomy, rotablation (RA) facilitates percutaneous coronary intervention (PCI) for complex lesions with severe calcification, in order to facilitate optimal stent delivery and expansion. Advanced age, renal disease and diabetes have all been associated with coronary artery calcification (CAC), with severe CAC affecting between 6 and 20% of patients treated with PCI. (1-3) **Results:** We present data using RA in University Hospital Dubrava from January 2016 to October 2018. The frequency of rotational atherectomy as a function of total PCI was 0.9% in 2016 and 1.2% in 2018 which is the same as in Europe countries (0.8% to 3.1%). During the last three years 27 RA was done, median age 66.7 ± 10.2 years. 92% of patients underwent RA had stabile angina and 8% acute coronary syndrome. In most cases the burr size was 1.25- 1.5 mm considering that plaque modification is easily achieved with a 1.25 or a 1.5 mm burr in most cases with a speed range between 135,000 and 180,000 rpm. RA was done in 75% in right coronary artery, 41% in left anterior descending artery and 4.1% in circumflex artery. In all patients drug-eluting stents were implanted. Due to periprocedural complications there was one contrast induced nephropathy with need for dialysis and one unsuccessful RA due to unsuccessful predilation even with highest burr used to plaque modification, therefore surgical revascularization was done. There were no complications associated to RA only. In our six months and one year follow up period no major adverse cardiac events was detected. **Conclusion:** RA is necessary technique in interventional cardiology canters that do complex PCI’s. With good choice of patients and mastering the technique, RA is safe and successful, as can be seen in our experience.

Keywords

rotablation, modification, calcification

DOI

Literature

1. Barbato E, Carrié D, Dardas P, Fajadet J, Gaul G, Haude M, et al. European Association of Percutaneous Cardiovascular Interventions. European expert consensus on rotational atherectomy. EuroIntervention. 2015 May;11(1):30–6. https://doi.org/10.4244/EIJV11I1A6
2. Strisciuglio T, Barbato E. Rotational atherectomy: you will never regret using it but you often regret not having used it! EuroIntervention. 2016 Dec 20;12(12):1441–2. https://doi.org/10.4244/EIJV12I12A237
3. Iannaccone M, Colangelo S, Di Mario C, Garbo R. Double wire rotational atherectomy technique in a heavily calcified coronary bifurcation. EuroIntervention. 2018 Jun 20;14(2):204–5. https://doi.org/10.4244/EIJ-D-18-00001