Clinical experience with rotational atherectomy in University Hospital Dubrava

    Authors

    Keywords

    rotablation, modification, calcification

    DOI

    https://doi.org/10.15836/ccar2018.394

    Full Text

    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.

    Cardiologia Croatica
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    Clinical experience with rotational atherectomy in University Hospital Dubrava

    Extended Abstract
    Issue11-12
    Published
    Pages394
    PDF via DOIhttps://doi.org/10.15836/ccar2018.394
    rotablation
    modification
    calcification

    Authors

    Boris Starčević*ORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Petra VitlovORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Ante LisičićORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Ognjen ČančarevićORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Irzal HadžibegovićORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Aleksandar BlivajsORCIDUniversity Hospital Dubrava, Zagreb, Croatia

    Full Text

    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.