Baruah DK,Panigrahi NK and Baruah N
Objective: Calcified coronary lesion poses formidable challenge to interventional cardiologist. This study was to evaluate safety and efficacy of Rotational Atherectomy (RA) as a lesion modifying tool for calcified lesions prior to DES implantation in ‘real world’ practice.
Methods: From April 2014 to March 2015, all consecutive patients who underwent RA in our hospital located in south India were enrolled. The relevant clinical and angiographic features at the time of index PCI with immediate and 6-month clinical follow-up data were analyzed.
Results: Total no. of cases were 39, mean age of 67.3 ± 6.4 years. 26 (66.7%) were male. Risk factor: HTN in 35 cases (89.7%), DM in 30 (76.9%), smoking in 4 (10.2%). 31 (79.5%) patients presented with acute coronary syndrome. 31 (79.5%) cases had SVD. The mean SYNTAX score was 24 ± 11. 25 cases (64.1%) had lesion in LAD. Mean lesion length was 23.9 ± 8 mm, mean% stenosis was 69 ± 7.3, and mean RD was 2.9 ± 1.1 mm. MLD before and after procedure was 1.1 mm and 2.8 mm respectively. 28 (71.8%) had severe calcification. 89.7% had Type-C lesions. 45 stents were used with a ratio of 1.15 stents/patient. 37 (97.4%) patients had DES with mean stent length of 26.22 ± 9.3 mm. Procedural success and clinical success were in 38 (97.4%) and 37 (94.9%) respectively. 36 cases (92.3%) cases were followed up clinically for 6 months. Out of 38 hospital survivors MACE was recorded in 3 (7.9%).
Conclusion: RA as a plaque modifying tool prior to stent implantation in DES era is safe with acceptable in-hospital and low out-of-hospital MACE.
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