Short and Long Term Outcome In Patients with Calcified Lesions Requiring Rotational Artherectomy

Authors

  • Lima Asrin Sayami Assistant Professor, Cardiology Department, National Institute of Cardiovascular Disease, Dhaka, Bangladesh, Dhaka, Bangladesh
  • Al Fazir Omar Consultant, Institut Jantung Negara, National Heart Institute, Kuala Lumpur, Malaysia
  • Sheikh Ziarat Islam Associate Professor, Cardiology Department, National Institute of Cardiovascular Disease, Dhaka, Bangladesh, Dhaka, Bangladesh
  • Subasni Govindan Cath labTechnician, Institut Jantung Negara, National Heart Institute, Kuala Lumpur, Malaysia
  • Zulaikha Zainal Data Analyst, Institut Jantung Negara, National Heart Institute, Kuala Lumpur, Malaysia
  • Rosli Mohd Ali Consultant, CVSKL, Kuala Lumpur, Malaysia

DOI:

https://doi.org/10.3329/bhj.v35i2.52901

Keywords:

Rotational Artherectomy, interventional techniques

Abstract

Objective: Despite the evolution of interventional techniques and operator experience, percutaneous revascularization of complex coronary lesions especially calcified lesions remains challenging because of lower procedural success and higher restenosis rates. Limited data are available on the effect of rotational atherectomy (RA) plus stenting in the treatment of complex calcified lesions of coronary artery disease. This study was aimed to investigate the characteristics, short and long term outcomes in patients undergoing RA.

Material and Methods: A database search was performed from the year 2008 to 2013 in National Heart institute, Malaysia. A total of 16009 patients who underwent PCIs were enrolled in 2 groups, RA group (258 patients) and non RA group (15751 patients). The Chi square test and Kaplan - Meier analysis were used.

Results: Male patients (73.6%) and elderly population (63.2%) were predominant in this study.The RA group had more co-morbidities such as diabetic on insulin (34%) and chronic kidney disease (57%). The lesions in RA group were more complex with higher Type C lesion (68.8%) and longer lesion (20.6%) compared to non RA group. Despite higher patient risk profile, the success rate of revascularization remains high in RA group (99.3%) as in non RA group (97%) (p value 0.89%). More importantly there were no significant difference in in-hospital mortality, myocardial infarction and stent thrombosis in both group (p value 0.1). In 1 year Kaplan - Meier survival graph, there were better survival noted in non RA group (97.7%) compare to RA (89.6%) (p value <0.005),

Conclusion: The use of RA allows debulking of a calcified lesion and possibly explains the higher acute procedural success rates. However, the lower 1-yearsurvival in the RA group highlights the higher associated baseline comorbitidity in this group. Therefore, besides coronary intervention, this RA group requires aggressive medical therapy through a multi-disciplinary approach.

Bangladesh Heart Journal 2020; 35(2) : 140-146

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Published

2021-04-07

How to Cite

Sayami, L. A., Omar, A. F., Islam, S. Z., Govindan, S., Zainal, Z., & Mohd Ali, R. (2021). Short and Long Term Outcome In Patients with Calcified Lesions Requiring Rotational Artherectomy. Bangladesh Heart Journal, 35(2), 140–146. https://doi.org/10.3329/bhj.v35i2.52901

Issue

Section

Original Articles