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CLC number: R541.4

On-line Access: 2012-08-01

Received: 2012-06-26

Revision Accepted: 2012-07-07

Crosschecked: 2012-07-06

Cited: 8

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Journal of Zhejiang University SCIENCE B 2012 Vol.13 No.8 P.645-651

http://doi.org/10.1631/jzus.B1201008


Complex coronary lesions and rotational atherectomy: one hospital’s experience


Author(s):  Jun Jiang, Yong Sun, Mei-xiang Xiang, Liang Dong, Xian-bao Liu, Xin-yang Hu, Yan Feng, Jian-an Wang

Affiliation(s):  Department of Cardiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China; more

Corresponding email(s):   Wang_jian_an@tom.com

Key Words:  Complex coronary lesions, Calcified coronary lesions, Rotational atherectomy, Drug eluting stents


Jun Jiang, Yong Sun, Mei-xiang Xiang, Liang Dong, Xian-bao Liu, Xin-yang Hu, Yan Feng, Jian-an Wang. Complex coronary lesions and rotational atherectomy: one hospital’s experience[J]. Journal of Zhejiang University Science B, 2012, 13(8): 645-651.

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author="Jun Jiang, Yong Sun, Mei-xiang Xiang, Liang Dong, Xian-bao Liu, Xin-yang Hu, Yan Feng, Jian-an Wang",
journal="Journal of Zhejiang University Science B",
volume="13",
number="8",
pages="645-651",
year="2012",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B1201008"
}

%0 Journal Article
%T Complex coronary lesions and rotational atherectomy: one hospital’s experience
%A Jun Jiang
%A Yong Sun
%A Mei-xiang Xiang
%A Liang Dong
%A Xian-bao Liu
%A Xin-yang Hu
%A Yan Feng
%A Jian-an Wang
%J Journal of Zhejiang University SCIENCE B
%V 13
%N 8
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%@ 1673-1581
%D 2012
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1201008

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T1 - Complex coronary lesions and rotational atherectomy: one hospital’s experience
A1 - Jun Jiang
A1 - Yong Sun
A1 - Mei-xiang Xiang
A1 - Liang Dong
A1 - Xian-bao Liu
A1 - Xin-yang Hu
A1 - Yan Feng
A1 - Jian-an Wang
J0 - Journal of Zhejiang University Science B
VL - 13
IS - 8
SP - 645
EP - 651
%@ 1673-1581
Y1 - 2012
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1201008


Abstract: 
Objective: To evaluate the safety and effectiveness of rotational atherectomy followed by drug eluting stent (DES) implantation in patients with complex coronary lesions. Methods: From August 2006 to August 2012, 253 consecutive patients with 289 lesions and who underwent rotational atherectomy in our center were enrolled in this study. Results: The overall procedure success rate was 98% with the cost of two (0.8%) coronary perforations, three (1.2%) dissections, five (2.0%) slow flows or no flows, three (1.2%) peri-procedure myocardial infarctions, and two (0.8%) in hospital deaths. During follow-up (mean three years), one (0.4%) patient died, two (0.8%) patients had acute myocardial infarction, 14 (5.5%) had restenosis, and target lesion revascularization occurred in eight patients (3.2%). Conclusions: rotational atherectomy followed by DES implantation is a safe and effective technique for patients with complex coronary lesions, especially calcified and non-dilatable lesions.

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference

[1]Bangalore, S., Vlachos, H.A., Selzer, F., Wilensky, R.L., Kip, K.E., Williams, D.O., Faxon, D.P., 2011. Percutaneous coronary intervention of moderate to severe calcified coronary lesions: insights from the National Heart, Lung, and Blood Institute Dynamic Registry. Catheter. Cardiovasc. Interv., 77(1):22-28.

[2]Benezet, J., Diaz de la Llera, L.S., Cubero, J.M., Villa, M., Fernandez-Quero, M., Sanchez-Gonzalez, A., 2011. Drug-eluting stents following rotational atherectomy for heavily calcified coronary lesions: long-term clinical outcomes. J. Invasive Cardiol., 23(1):28-32.

[3]Bredlau, C.E., Roubin, G.S., Leimgruber, P.P., Douglas, J.S.Jr., King, S.B.3rd, Gruentzig, A.R., 1985. In-hospital morbidity and mortality in patients undergoing elective coronary angioplasty. Circulation, 72(5):1044-1052.

[4]Camnitz, W.M., Keeley, E.C., 2010. Heavily calcified coronary arteries: the bane of an interventionalist’s existence. J. Interv. Cardiol., 23(3):254-255.

[5]Dardas, P., Mezilis, N., Ninios, V., Tsikaderis, D., Theofilogiannakos, E.K., Lampropoulos, S., 2011. The use of rotational atherectomy and drug-eluting stents in the treatment of heavily calcified coronary lesions. Hellenic. J. Cardiol., 52(5):399-406.

[6]Fujii, K., Mintz, G.S., Kobayashi, Y., Carlier, S.G., Takebayashi, H., Yasuda, T., Moussa, I., Dangas, G., Mehran, R., Lansky, A.J., et al., 2004. Contribution of stent underexpansion to recurrence after sirolimus-eluting stent implantation for in-stent restenosis. Circulation, 109(9):1085-1088.

[7]Kataoka, Y., Wolski, K., Uno, K., Puri, R., Tuzcu, E.M., Nissen, S.E., Nicholls, S.J., 2012. Spotty calcification as a marker of accelerated progression of coronary atherosclerosis: insights from serial intravascular ultrasound. J. Am. Coll. Cardiol., 59(18):1592-1597.

[8]Kawaguchi, R., Tsurugaya, H., Hoshizaki, H., Toyama, T., Oshima, S., Taniguchi, K., 2008. Impact of lesion calcification on clinical and angiographic outcome after sirolimus-eluting stent implantation in real-world patients. Cardiovasc. Revasc. Med., 9(1):2-8.

[9]Lemos, P.A., Hoye, A., Goedhart, D., Arampatzis, C.A., Saia, F., van der Giessen, W.J., McFadden, E., Sianos, G., Smits, P.C., Hofma, S.H., et al., 2004. Clinical, angiographic, and procedural predictors of angiographic restenosis after sirolimus-eluting stent implantation in complex patients: an evaluation from the Rapamycin-Eluting Stent Evaluated at Rotterdam Cardiology Hospital (RESEARCH) study. Circulation, 109(11):1366-1370.

[10]MacIsaac, A.I., Bass, T.A., Buchbinder, M., Cowley, M.J., Leon, M.B., Warth, D.C., Whitlow, P.L., 1995. High speed rotational atherectomy: outcome in calcified and noncalcified coronary artery lesions. J. Am. Coll. Cardiol., 26(3):731-736.

[11]Mauri, L., Reisman, M., Buchbinder, M., Popma, J.J., Sharma, S.K., Cutlip, D.E., Ho, K.K., Prpic, R., Zimetbaum, P.J., Kuntz, R.E., 2003. Comparison of rotational atherectomy with conventional balloon angioplasty in the prevention of restenosis of small coronary arteries: results of the Dilatation vs. Ablation Revascularization Trial Targeting Restenosis (DART). Am. Heart J., 145(5):847-854.

[12]Pocock, S.J., Lansky, A.J., Mehran, R., Popma, J.J., Fahy, M.P., Na, Y., Dangas, G., Moses, J.W., Pucelikova, T., Kandzari, D.E., et al., 2008. Angiographic surrogate end points in drug-eluting stent trials: a systematic evaluation based on individual patient data from 11 randomized, controlled trials. J. Am. Coll. Cardiol., 51(1):23-32.

[13]Shimoyama, Y., Tsuruta, Y., Niwa, T., 2012. Coronary artery calcification score is associated with mortality in Japanese hemodialysis patients. J. Ren. Nutr., 22(1):139-142.

[14]Stavroulopoulos, A., Porter, C.J., Pointon, K., Monaghan, J.M., Roe, S.D., Cassidy, M.J., 2011. Evolution of coronary artery calcification in patients with chronic kidney disease Stages 3 and 4, with and without diabetes. Nephrol. Dial. Transplant., 26(8):2582-2589.

[15]Tran, T., Brown, M., Lasala, J., 2008. An evidence-based approach to the use of rotational and directional coronary atherectomy in the era of drug-eluting stents: when does it make sense? Catheter. Cardiovasc. Interv., 72(5):650-662.

[16]Vavuranakis, M., Toutouzas, K., Stefanadis, C., Chrisohou, C., Markou, D., Toutouzas, P., 2001. Stent deployment in calcified lesions: can we overcome calcific restraint with high-pressure balloon inflations? Catheter. Cardiovasc. Interv., 52(2):164-172.

[17]Virmani, R., Farb, A., Burke, A.P., 1994. Coronary angioplasty from the perspective of atherosclerotic plaque: morphologic predictors of immediate success and restenosis. Am. Heart J., 127(1):163-179.

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