Rotational atherectomy in very long lesions: Results for the ROTATE registry

Mario Iannaccone, Umberto Barbero, Fabrizio D'ascenzo, Azeem Latib, Mauro Pennacchi, Marco Luciano Rossi, Fabrizio Ugo, Emanuele Meliga, Hiroyoshi Kawamoto, Claudio Moretti, Alfonso Ielasi, Roberto Garbo, Antonio Colombo, Gennaro Sardella, Giacomo G. Boccuzzi

Research output: Contribution to journalArticle

Abstract

Background: Rotational atherectomy (RA) is relatively contraindicated in patients with lesions ≥25 mm of length. Aim of this study was to evaluate RA safety and efficacy in this subset of patients with new technology and devices. Methods and Results: From April 2002 to August 2013, the ROTATE registry included all consecutive patients undergoing RA in 8 centres. They were divided into shorter lesion group (SLG, lesions <25 mm) and longer lesion group (LLG, lesions ≥ 25 mm). The angiographic success (AS) was the primary end point. Procedural complications (PC), a composite end point of procedural perforation, slow flow/no flow, and in-hospital major acute cardiovascular events (MACE), were secondary end points, along with death, nonfatal MI, target lesion revascularization, and MACE during follow-up. Sensitivity analysis was performed according to generation of DES. 1186 patients were included: 51.5% in SLG and 48.4% in LLG. Mean age was 70.4 ± 9.3 years, 64.5% were male. AS and PC did not differ between the two groups (93% vs 91%, p = 0.24 and 9.8 vs 9.4%, p = 0.84). During follow-up (27.6 ± 22.9 months), MACE did not differ between the two groups (28% vs 29.1%, p = 0.95). At multivariate analysis chronic kidney disease, male gender increased risk of MACE (HR 1.94, IQR 1.29–2.0, p = 0.01, HR 0.52, IQR 0.34–0.79, p = 0.01) while second-generation DES seemed protective (HR 0.53, IQR 0.31–0.88, p = 0.02). Data were confirmed at sensitivity analysis for second-generation DES (759 pts, 63.9%). No differences were found in this subpopulation between the two groups in term of AS, PC, and long-term MACE (93.6% vs 93.5%, p = 0.28, 11.9% vs 9.4%, p = 0.32 and 25.5% vs 23.9%, p = 0.72, respectively). Conclusions: Treating coronary lesions ≥ 25 mm length with RA does not impact short- and long-term outcome, in particular, in patients with second-generation DES. © 2016 Wiley Periodicals, Inc.
Original languageEnglish
Pages (from-to)E164 - E172
JournalCatheterization and Cardiovascular Interventions
Volume88
Issue number6
DOIs
Publication statusPublished - Nov 15 2016

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Coronary Atherectomy
Registries
Chronic Renal Insufficiency
Multivariate Analysis
Technology
Safety
Equipment and Supplies

Keywords

  • calcific lesion
  • rotablator
  • rotational atherectomy
  • second-generation DES

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Iannaccone, M., Barbero, U., D'ascenzo, F., Latib, A., Pennacchi, M., Rossi, M. L., ... Boccuzzi, G. G. (2016). Rotational atherectomy in very long lesions: Results for the ROTATE registry. Catheterization and Cardiovascular Interventions, 88(6), E164 - E172. https://doi.org/10.1002/ccd.26548

Rotational atherectomy in very long lesions: Results for the ROTATE registry. / Iannaccone, Mario; Barbero, Umberto; D'ascenzo, Fabrizio; Latib, Azeem; Pennacchi, Mauro; Rossi, Marco Luciano; Ugo, Fabrizio; Meliga, Emanuele; Kawamoto, Hiroyoshi; Moretti, Claudio; Ielasi, Alfonso; Garbo, Roberto; Colombo, Antonio; Sardella, Gennaro; Boccuzzi, Giacomo G.

In: Catheterization and Cardiovascular Interventions, Vol. 88, No. 6, 15.11.2016, p. E164 - E172.

Research output: Contribution to journalArticle

Iannaccone, M, Barbero, U, D'ascenzo, F, Latib, A, Pennacchi, M, Rossi, ML, Ugo, F, Meliga, E, Kawamoto, H, Moretti, C, Ielasi, A, Garbo, R, Colombo, A, Sardella, G & Boccuzzi, GG 2016, 'Rotational atherectomy in very long lesions: Results for the ROTATE registry', Catheterization and Cardiovascular Interventions, vol. 88, no. 6, pp. E164 - E172. https://doi.org/10.1002/ccd.26548
Iannaccone, Mario ; Barbero, Umberto ; D'ascenzo, Fabrizio ; Latib, Azeem ; Pennacchi, Mauro ; Rossi, Marco Luciano ; Ugo, Fabrizio ; Meliga, Emanuele ; Kawamoto, Hiroyoshi ; Moretti, Claudio ; Ielasi, Alfonso ; Garbo, Roberto ; Colombo, Antonio ; Sardella, Gennaro ; Boccuzzi, Giacomo G. / Rotational atherectomy in very long lesions: Results for the ROTATE registry. In: Catheterization and Cardiovascular Interventions. 2016 ; Vol. 88, No. 6. pp. E164 - E172.
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abstract = "Background: Rotational atherectomy (RA) is relatively contraindicated in patients with lesions ≥25 mm of length. Aim of this study was to evaluate RA safety and efficacy in this subset of patients with new technology and devices. Methods and Results: From April 2002 to August 2013, the ROTATE registry included all consecutive patients undergoing RA in 8 centres. They were divided into shorter lesion group (SLG, lesions <25 mm) and longer lesion group (LLG, lesions ≥ 25 mm). The angiographic success (AS) was the primary end point. Procedural complications (PC), a composite end point of procedural perforation, slow flow/no flow, and in-hospital major acute cardiovascular events (MACE), were secondary end points, along with death, nonfatal MI, target lesion revascularization, and MACE during follow-up. Sensitivity analysis was performed according to generation of DES. 1186 patients were included: 51.5{\%} in SLG and 48.4{\%} in LLG. Mean age was 70.4 ± 9.3 years, 64.5{\%} were male. AS and PC did not differ between the two groups (93{\%} vs 91{\%}, p = 0.24 and 9.8 vs 9.4{\%}, p = 0.84). During follow-up (27.6 ± 22.9 months), MACE did not differ between the two groups (28{\%} vs 29.1{\%}, p = 0.95). At multivariate analysis chronic kidney disease, male gender increased risk of MACE (HR 1.94, IQR 1.29–2.0, p = 0.01, HR 0.52, IQR 0.34–0.79, p = 0.01) while second-generation DES seemed protective (HR 0.53, IQR 0.31–0.88, p = 0.02). Data were confirmed at sensitivity analysis for second-generation DES (759 pts, 63.9{\%}). No differences were found in this subpopulation between the two groups in term of AS, PC, and long-term MACE (93.6{\%} vs 93.5{\%}, p = 0.28, 11.9{\%} vs 9.4{\%}, p = 0.32 and 25.5{\%} vs 23.9{\%}, p = 0.72, respectively). Conclusions: Treating coronary lesions ≥ 25 mm length with RA does not impact short- and long-term outcome, in particular, in patients with second-generation DES. {\circledC} 2016 Wiley Periodicals, Inc.",
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T1 - Rotational atherectomy in very long lesions: Results for the ROTATE registry

AU - Iannaccone, Mario

AU - Barbero, Umberto

AU - D'ascenzo, Fabrizio

AU - Latib, Azeem

AU - Pennacchi, Mauro

AU - Rossi, Marco Luciano

AU - Ugo, Fabrizio

AU - Meliga, Emanuele

AU - Kawamoto, Hiroyoshi

AU - Moretti, Claudio

AU - Ielasi, Alfonso

AU - Garbo, Roberto

AU - Colombo, Antonio

AU - Sardella, Gennaro

AU - Boccuzzi, Giacomo G.

PY - 2016/11/15

Y1 - 2016/11/15

N2 - Background: Rotational atherectomy (RA) is relatively contraindicated in patients with lesions ≥25 mm of length. Aim of this study was to evaluate RA safety and efficacy in this subset of patients with new technology and devices. Methods and Results: From April 2002 to August 2013, the ROTATE registry included all consecutive patients undergoing RA in 8 centres. They were divided into shorter lesion group (SLG, lesions <25 mm) and longer lesion group (LLG, lesions ≥ 25 mm). The angiographic success (AS) was the primary end point. Procedural complications (PC), a composite end point of procedural perforation, slow flow/no flow, and in-hospital major acute cardiovascular events (MACE), were secondary end points, along with death, nonfatal MI, target lesion revascularization, and MACE during follow-up. Sensitivity analysis was performed according to generation of DES. 1186 patients were included: 51.5% in SLG and 48.4% in LLG. Mean age was 70.4 ± 9.3 years, 64.5% were male. AS and PC did not differ between the two groups (93% vs 91%, p = 0.24 and 9.8 vs 9.4%, p = 0.84). During follow-up (27.6 ± 22.9 months), MACE did not differ between the two groups (28% vs 29.1%, p = 0.95). At multivariate analysis chronic kidney disease, male gender increased risk of MACE (HR 1.94, IQR 1.29–2.0, p = 0.01, HR 0.52, IQR 0.34–0.79, p = 0.01) while second-generation DES seemed protective (HR 0.53, IQR 0.31–0.88, p = 0.02). Data were confirmed at sensitivity analysis for second-generation DES (759 pts, 63.9%). No differences were found in this subpopulation between the two groups in term of AS, PC, and long-term MACE (93.6% vs 93.5%, p = 0.28, 11.9% vs 9.4%, p = 0.32 and 25.5% vs 23.9%, p = 0.72, respectively). Conclusions: Treating coronary lesions ≥ 25 mm length with RA does not impact short- and long-term outcome, in particular, in patients with second-generation DES. © 2016 Wiley Periodicals, Inc.

AB - Background: Rotational atherectomy (RA) is relatively contraindicated in patients with lesions ≥25 mm of length. Aim of this study was to evaluate RA safety and efficacy in this subset of patients with new technology and devices. Methods and Results: From April 2002 to August 2013, the ROTATE registry included all consecutive patients undergoing RA in 8 centres. They were divided into shorter lesion group (SLG, lesions <25 mm) and longer lesion group (LLG, lesions ≥ 25 mm). The angiographic success (AS) was the primary end point. Procedural complications (PC), a composite end point of procedural perforation, slow flow/no flow, and in-hospital major acute cardiovascular events (MACE), were secondary end points, along with death, nonfatal MI, target lesion revascularization, and MACE during follow-up. Sensitivity analysis was performed according to generation of DES. 1186 patients were included: 51.5% in SLG and 48.4% in LLG. Mean age was 70.4 ± 9.3 years, 64.5% were male. AS and PC did not differ between the two groups (93% vs 91%, p = 0.24 and 9.8 vs 9.4%, p = 0.84). During follow-up (27.6 ± 22.9 months), MACE did not differ between the two groups (28% vs 29.1%, p = 0.95). At multivariate analysis chronic kidney disease, male gender increased risk of MACE (HR 1.94, IQR 1.29–2.0, p = 0.01, HR 0.52, IQR 0.34–0.79, p = 0.01) while second-generation DES seemed protective (HR 0.53, IQR 0.31–0.88, p = 0.02). Data were confirmed at sensitivity analysis for second-generation DES (759 pts, 63.9%). No differences were found in this subpopulation between the two groups in term of AS, PC, and long-term MACE (93.6% vs 93.5%, p = 0.28, 11.9% vs 9.4%, p = 0.32 and 25.5% vs 23.9%, p = 0.72, respectively). Conclusions: Treating coronary lesions ≥ 25 mm length with RA does not impact short- and long-term outcome, in particular, in patients with second-generation DES. © 2016 Wiley Periodicals, Inc.

KW - calcific lesion

KW - rotablator

KW - rotational atherectomy

KW - second-generation DES

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