Objectives. Our goal was to assess the mid-term clinical and angiographic efficacy of rotational atherectomy preceding sirolimus-eluting stent (SES) implantation. Background. Nondilatable calcified coronary lesions have been excluded from all clinical trials involving the SES. The clinical and angiographic efficacy of rotational atherectomy to enable SES implantation is not known. Methods. We performed rotational atherectomy to enable SES implantation in 44 consecutive patients (34 men; mean [± 1 SD] age 67 ± 9 years). They presented with a total of 47 nondilatable lesions (mean length 22.7 ± 13.7 mm). Results. Rotational atherectomy enabled SES implantation in all cases. The cumulative incidences of target lesion revascularizations and major adverse cardiac events at 7.7 ± 3.0 months were 9.1% (4 patients; 95% confidence interval [CI], 2.5-21.7%) and 11.4% (5 patients; 95% CI, 3.8 24.6%), respectively. Angiographic follow-up obtained from 29 patients (31 lesions) at 7.0 ± 2.8 months revealed a median late loss in-stent of 0.31 mm and in-segment of 0.22 mm. Binary restenosis was observed in-stent in 3 lesions (9.7%; 95% CI, 2.0-25.8%) and at the stent margins in another 3 lesions (in-segment restenosis 19.4%; 95% CI, 7.5-37.5%). Conclusions. It is concluded that rotational atherectomy to enable SES implantation in long, nondilatable calcified coronary lesions is feasible and safe, with acceptable mid-term efficacy.
|Number of pages||7|
|Journal||Vascular Disease Management|
|Publication status||Published - May 2007|
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine