Eftychiou, C, Barmby, DS, Wilson, SJ et al. (7 more authors) (2016) Cardiovascular Outcomes Following Rotational Atherectomy: A UK Multicentre Experience. Catheterization and Cardiovascular Interventions, 88 (4). pp. 546-553. ISSN 1522-1946
Abstract
Objectives: To identify factors associated with outcomes following rotational atherectomy (RA). Background: RA is an effective way to mechanically modify heavily calcified lesions before stenting; however its outcomes are not well defined. Methods and Results: Retrospective evaluation of all patients who underwent RA in three large UK centers (Leeds General Infirmary (LGI), Royal Infirmary of Edinburgh (RIE) and University Hospital of North Staffordshire (UHNS)) from March 2005 to January 2013. Five hundred and eighteen patients had RA with median follow-up period of 22 months. About 68.3% were male, 28.7% had DM and 34.6% were treated because of ACS. Stents were deployed in 97.3% of the patients while 30.7% of the procedures were performed transradially. Maximum burr was ≤1.75 mm in 85.5% and the mean SYNTAX score was 19.5 ± 11.6. Peri-procedural complications occurred in 6.4% and vascular access complications in 1.9%. Outcomes in the follow-up period were: MACE 17.8%, cardiac death 7.1%, MI 11.7%, TVR 7.5%, all-cause death 13.7%, definite stent thrombosis (ST) 1.4% and stroke 2.9%. Patients with intermediate and high SYNTAX scores were more likely to suffer MACE, cardiac death, MI, all-cause death and ST. Patients with a SYNTAX score >32 were also more likely to have a peri-procedural complication. Multiple logistic regression analysis showed that the presence of PVD (P = 0.026, OR = 2.0), DM (P = 0.008, OR = 2.1), ACS presentation (P = 0.011, OR = 2.1) and SYNTAX score ≥23 (P = 0.02, OR = 1.9) had a significant association with MACE. Conclusions: RA is safe and effective, with high rate of procedural success and relatively low incidence of MACE. PVD, DM, ACS presentation and SYNTAX score were significant predictors for MACE. © 2016 Wiley Periodicals, Inc.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2016 Wiley Periodicals, Inc. This is the peer reviewed version of the following article: Eftychiou, C., Barmby, D. S., Wilson, S. J., Ubaid, S., Markwick, A. J., Makri, L., Blaxill, J. M., Spratt, J. C., Gunning, M. and Greenwood, J. P. (2016), Cardiovascular Outcomes Following Rotational Atherectomy: A UK Multicentre Experience. Cathet. Cardiovasc. Intervent., 88: 546–553. doi: 10.1002/ccd.26587, which has been published in final form at https://doi.org/10.1002/ccd.26587. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. |
Keywords: | atherectomy;directional/rotational;coronary artery disease;percutaneous coronary intervention |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) > Division of Biomedical Imaging (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 14 Jun 2016 13:49 |
Last Modified: | 03 Nov 2017 03:19 |
Published Version: | https://doi.org/10.1002/ccd.26587 |
Status: | Published |
Publisher: | Wiley |
Identification Number: | 10.1002/ccd.26587 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:100858 |
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