In-hospital and midterm clinical outcomes of rotational atherectomy followed by stent implantation: The ROTATE multicentre registry

Hiroyoshi Kawamoto, Azeem Latib, Neil Ruparelia, Alfonso Ielasi, Fabrizio D'Ascenzo, Mauro Pennacchi, Gennaro Sardella, Roberto Garbo, Emanuele Meliga, Claudio Moretti, Marco Luciano Rossi, Patrizia Presbitero, Caroline J. Magri, Sunao Nakamura, Antonio Colombo, Giacomo G. Boccuzzi, Emanuele Barbato

Research output: Contribution to journalArticle

Abstract

Aims: The aim of this multicentre study was to investigate the in-hospital and midterm outcomes of rotational atherectomy (RA) followed by metallic stent implantation. Methods and results: Between 2002 and 2013, 1,176 de novo lesions with calcified coronary lesions treated by RA and metallic stent implantation at nine institutions were assessed. Patients with ST-segment elevation myocardial infarction (STEMI) within 30 days, cardiogenic shock before the procedure, lesions with thrombus, and in-stent restenosis were excluded from the current analysis. In-hospital major adverse cardiac events (MACE) occurred in 8.3% of cases, mainly driven by periprocedural myocardial infarction. The incidence of MACE was 16.0% at one-year and 24.9% at two-year follow-up, both driven by target vessel revascularisation (13.5% at one year and 19.8% at two years). Multivariable analysis revealed that dialysis was an independent predictor for both in-hospital MACE (OR 2.33, 95% CI: 1.11-4.87, p=0.03) and follow-up MACE (HR 4.14, 95% CI: 2.87-5.96, p<0.001), whilst drug-eluting stent (DES) use was associated with a reduction in follow-up MACE (HR 0.42, 95% CI: 0.26-0.67, p<0.001). Conclusions: RA appears to be safe and effective with acceptable in-hospital and follow-up MACE considering the severity of patient and lesion characteristics. DES implantation following RA was associated with a reduction in MACE during the follow-up period.

Original languageEnglish
Pages (from-to)1448-1456
Number of pages9
JournalEuroIntervention
Volume12
Issue number12
DOIs
Publication statusPublished - Dec 1 2016

Keywords

  • Atherectomy
  • Calcified lesions
  • Coronary
  • Drug-eluting stents
  • Intervention
  • Percutaneous
  • Rotational

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Kawamoto, H., Latib, A., Ruparelia, N., Ielasi, A., D'Ascenzo, F., Pennacchi, M., Sardella, G., Garbo, R., Meliga, E., Moretti, C., Rossi, M. L., Presbitero, P., Magri, C. J., Nakamura, S., Colombo, A., Boccuzzi, G. G., & Barbato, E. (2016). In-hospital and midterm clinical outcomes of rotational atherectomy followed by stent implantation: The ROTATE multicentre registry. EuroIntervention, 12(12), 1448-1456. https://doi.org/10.4244/EIJ-D-16-00386