Rotational atherectomy for chronically and totally occluded coronary lesions: A propensity score-matched outcomes study
BackgroundDespite advances being made in techniques and devices, certain chronic total occlusion (CTO) lesions remain uncrossable or undilatable. Rotational atherectomy (RA) is usually necessary for such lesions to achieve successful revascularization.MethodsInformation regarding consecutive patient...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-12-01
|
| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1061812/full |
| _version_ | 1828261594410254336 |
|---|---|
| author | Tien-Chien Tsai Wei-Jung Lo Wei-Jhong Chen Chih-Hung Lai Chih-Hung Lai Chih-Hung Lai Chieh-Shou Su Chieh-Shou Su Chieh-Shou Su Wei-Chun Chang Wei-Chun Chang Chi-Yen Wang Chi-Yen Wang Chi-Yen Wang Tsun-Jui Liu Tsun-Jui Liu Tsun-Jui Liu Kae-Woei Liang Kae-Woei Liang Kae-Woei Liang Wen-Lieng Lee Wen-Lieng Lee Wen-Lieng Lee Yu-Wei Chen Yu-Wei Chen Yu-Wei Chen Yu-Wei Chen |
| author_facet | Tien-Chien Tsai Wei-Jung Lo Wei-Jhong Chen Chih-Hung Lai Chih-Hung Lai Chih-Hung Lai Chieh-Shou Su Chieh-Shou Su Chieh-Shou Su Wei-Chun Chang Wei-Chun Chang Chi-Yen Wang Chi-Yen Wang Chi-Yen Wang Tsun-Jui Liu Tsun-Jui Liu Tsun-Jui Liu Kae-Woei Liang Kae-Woei Liang Kae-Woei Liang Wen-Lieng Lee Wen-Lieng Lee Wen-Lieng Lee Yu-Wei Chen Yu-Wei Chen Yu-Wei Chen Yu-Wei Chen |
| author_sort | Tien-Chien Tsai |
| collection | DOAJ |
| description | BackgroundDespite advances being made in techniques and devices, certain chronic total occlusion (CTO) lesions remain uncrossable or undilatable. Rotational atherectomy (RA) is usually necessary for such lesions to achieve successful revascularization.MethodsInformation regarding consecutive patients who underwent coronary RA was retrieved from the catheterization laboratory database. Patients who underwent RA for CTO lesion refractory using other conventional devices were recruited, with propensity score-matched cases serving as controls.ResultsA total of 411 patients underwent coronary RA in the study period. Most patients had high-risk features (65.7% had acute coronary syndrome (ACS), 14.1% ischemic cardiomyopathy, and 5.1% cardiogenic shock), while only 20.2% of the patients had stable angina. Among them, 44 patients underwent RA for CTO lesions (CTO group), whereas the propensity score matched controls consist of 37 patients (non-CTO group). The baseline characteristics, high-risk features, coronary artery disease (CAD) vessel numbers, left ventricular function and biochemistry profiles of both groups were the same except for more patients with diabetes (67.6% vs. 45.5%, p = 0.046) in the non-CTO group and more 1.25 mm burr uses in the CTO group. There were no significant differences in acute procedural outcomes or incidence of acute contrast-induced nephropathy (CIN), and no patient demanded emergent CABG or died during the procedure. There was no significant difference in major adverse cardiovascular events (MACE), CV MACE or individual components between the two groups in the hospital, at 30, 90, and 180 days or at 1 year.ConclusionIn comparison with the propensity risk factor scores-matched controls, there was no difference in procedural complications, acute CIN or clinical outcomes during various stages of RA for CTO lesions. RA for CTO patients was highly efficient and showed safety and outcome profiles similar to those for non-CTO lesions. |
| first_indexed | 2024-04-13T03:42:11Z |
| format | Article |
| id | doaj.art-254707dc0b624851993e62f19de019ba |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-13T03:42:11Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-254707dc0b624851993e62f19de019ba2022-12-22T03:04:06ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-12-01910.3389/fcvm.2022.10618121061812Rotational atherectomy for chronically and totally occluded coronary lesions: A propensity score-matched outcomes studyTien-Chien Tsai0Wei-Jung Lo1Wei-Jhong Chen2Chih-Hung Lai3Chih-Hung Lai4Chih-Hung Lai5Chieh-Shou Su6Chieh-Shou Su7Chieh-Shou Su8Wei-Chun Chang9Wei-Chun Chang10Chi-Yen Wang11Chi-Yen Wang12Chi-Yen Wang13Tsun-Jui Liu14Tsun-Jui Liu15Tsun-Jui Liu16Kae-Woei Liang17Kae-Woei Liang18Kae-Woei Liang19Wen-Lieng Lee20Wen-Lieng Lee21Wen-Lieng Lee22Yu-Wei Chen23Yu-Wei Chen24Yu-Wei Chen25Yu-Wei Chen26Cardiovascular Center, Taichung Veterans General Hospital, Taichung, TaiwanCardiovascular Center, Taichung Veterans General Hospital, Taichung, TaiwanCardiovascular Center, Taichung Veterans General Hospital, Taichung, TaiwanCardiovascular Center, Taichung Veterans General Hospital, Taichung, TaiwanInstitute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanCardiovascular Research Center, College of Medicine, National Chung Hsing University, Taichung, TaiwanCardiovascular Center, Taichung Veterans General Hospital, Taichung, TaiwanCardiovascular Research Center, College of Medicine, National Chung Hsing University, Taichung, TaiwanDepartment of Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanFeng-Yuan Hospital, Ministry of Health and Welfare, Taichung, TaiwanDepartment of Life Sciences, Tunghai University, Taichung, TaiwanCardiovascular Center, Taichung Veterans General Hospital, Taichung, TaiwanCardiovascular Research Center, College of Medicine, National Chung Hsing University, Taichung, TaiwanInstitute of Medicine, Chung Shan Medical University, Taichung, TaiwanCardiovascular Center, Taichung Veterans General Hospital, Taichung, TaiwanCardiovascular Research Center, College of Medicine, National Chung Hsing University, Taichung, TaiwanDepartment of Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanCardiovascular Center, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanDepartment of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, TaiwanCardiovascular Center, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanDepartment of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, TaiwanCardiovascular Center, Taichung Veterans General Hospital, Taichung, TaiwanInstitute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanCardiovascular Research Center, College of Medicine, National Chung Hsing University, Taichung, TaiwanDepartment of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, TaiwanBackgroundDespite advances being made in techniques and devices, certain chronic total occlusion (CTO) lesions remain uncrossable or undilatable. Rotational atherectomy (RA) is usually necessary for such lesions to achieve successful revascularization.MethodsInformation regarding consecutive patients who underwent coronary RA was retrieved from the catheterization laboratory database. Patients who underwent RA for CTO lesion refractory using other conventional devices were recruited, with propensity score-matched cases serving as controls.ResultsA total of 411 patients underwent coronary RA in the study period. Most patients had high-risk features (65.7% had acute coronary syndrome (ACS), 14.1% ischemic cardiomyopathy, and 5.1% cardiogenic shock), while only 20.2% of the patients had stable angina. Among them, 44 patients underwent RA for CTO lesions (CTO group), whereas the propensity score matched controls consist of 37 patients (non-CTO group). The baseline characteristics, high-risk features, coronary artery disease (CAD) vessel numbers, left ventricular function and biochemistry profiles of both groups were the same except for more patients with diabetes (67.6% vs. 45.5%, p = 0.046) in the non-CTO group and more 1.25 mm burr uses in the CTO group. There were no significant differences in acute procedural outcomes or incidence of acute contrast-induced nephropathy (CIN), and no patient demanded emergent CABG or died during the procedure. There was no significant difference in major adverse cardiovascular events (MACE), CV MACE or individual components between the two groups in the hospital, at 30, 90, and 180 days or at 1 year.ConclusionIn comparison with the propensity risk factor scores-matched controls, there was no difference in procedural complications, acute CIN or clinical outcomes during various stages of RA for CTO lesions. RA for CTO patients was highly efficient and showed safety and outcome profiles similar to those for non-CTO lesions.https://www.frontiersin.org/articles/10.3389/fcvm.2022.1061812/fullcoronary arter diseasechronic total occlusionpercutaneous coronary interventionpropensity scorerotational atherectomy |
| spellingShingle | Tien-Chien Tsai Wei-Jung Lo Wei-Jhong Chen Chih-Hung Lai Chih-Hung Lai Chih-Hung Lai Chieh-Shou Su Chieh-Shou Su Chieh-Shou Su Wei-Chun Chang Wei-Chun Chang Chi-Yen Wang Chi-Yen Wang Chi-Yen Wang Tsun-Jui Liu Tsun-Jui Liu Tsun-Jui Liu Kae-Woei Liang Kae-Woei Liang Kae-Woei Liang Wen-Lieng Lee Wen-Lieng Lee Wen-Lieng Lee Yu-Wei Chen Yu-Wei Chen Yu-Wei Chen Yu-Wei Chen Rotational atherectomy for chronically and totally occluded coronary lesions: A propensity score-matched outcomes study Frontiers in Cardiovascular Medicine coronary arter disease chronic total occlusion percutaneous coronary intervention propensity score rotational atherectomy |
| title | Rotational atherectomy for chronically and totally occluded coronary lesions: A propensity score-matched outcomes study |
| title_full | Rotational atherectomy for chronically and totally occluded coronary lesions: A propensity score-matched outcomes study |
| title_fullStr | Rotational atherectomy for chronically and totally occluded coronary lesions: A propensity score-matched outcomes study |
| title_full_unstemmed | Rotational atherectomy for chronically and totally occluded coronary lesions: A propensity score-matched outcomes study |
| title_short | Rotational atherectomy for chronically and totally occluded coronary lesions: A propensity score-matched outcomes study |
| title_sort | rotational atherectomy for chronically and totally occluded coronary lesions a propensity score matched outcomes study |
| topic | coronary arter disease chronic total occlusion percutaneous coronary intervention propensity score rotational atherectomy |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1061812/full |
| work_keys_str_mv | AT tienchientsai rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy AT weijunglo rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy AT weijhongchen rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy AT chihhunglai rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy AT chihhunglai rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy AT chihhunglai rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy AT chiehshousu rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy AT chiehshousu rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy AT chiehshousu rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy AT weichunchang rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy AT weichunchang rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy AT chiyenwang rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy AT chiyenwang rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy AT chiyenwang rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy AT tsunjuiliu rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy AT tsunjuiliu rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy AT tsunjuiliu rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy AT kaewoeiliang rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy AT kaewoeiliang rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy AT kaewoeiliang rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy AT wenlienglee rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy AT wenlienglee rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy AT wenlienglee rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy AT yuweichen rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy AT yuweichen rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy AT yuweichen rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy AT yuweichen rotationalatherectomyforchronicallyandtotallyoccludedcoronarylesionsapropensityscorematchedoutcomesstudy |