Outcomes after Percutaneous Coronary Intervention in Patients with Extremely Calcified Left Main Lesions
<i>Background and Objectives:</i> Available data with regard to the outcomes of patients with severely calcified left main (LM) lesions after revascularization by percutaneous coronary intervention (PCI) when compared to non-calcified LM lesions is unclear. <i>Materials and Methods...
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| Format: | Article |
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MDPI AG
2023-04-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/5/825 |
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| author | Silviu Dumitrascu Daniela Bartos Claudiu Ungureanu |
| author_facet | Silviu Dumitrascu Daniela Bartos Claudiu Ungureanu |
| author_sort | Silviu Dumitrascu |
| collection | DOAJ |
| description | <i>Background and Objectives:</i> Available data with regard to the outcomes of patients with severely calcified left main (LM) lesions after revascularization by percutaneous coronary intervention (PCI) when compared to non-calcified LM lesions is unclear. <i>Materials and Methods:</i> The present study sought to retrospectively investigate in hospital and 1 year post-intervention outcomes of patients with extremely calcified LM lesions after PCI facilitated by calcium-dedicated devices (CdD). Seventy consecutive patients with LM PCI were included. CdD requirement was based on suboptimal results after balloon angioplasty. <i>Results:</i> Twenty-two patients (31.4%) required at least one CdD, while nine patients (12.8%) required at least two. Intravascular lithotripsy and rotational atherectomy were the predominantly used methods(59.1% and 40.9% respectively, for in-group ratios), while ultra-high pressure and scoring balloons contributed the least to lesion preparation (9%). In 20 patients (28.5%), severe or moderate calcifications were angiographically identified, but non-compliant balloon predilation was adequate and CdD were not necessary. Total procedural time was significantly higher in CdD group (<i>p</i>-value 0.02). Procedural and clinical success were obtained in 100% of cases. There were no major adverse cardiac and cerebrovascular events (MACCE) recorded during hospitalization. MACCE at 1 year post-procedure were recorded in three patients (4.2% overall). All three events were documented in the control group (6.2%), and no events were recorded in CdD group (<i>p</i>-value 0.23). There was one cardiac death at 10 months and two target lesion revascularizations for side-branch restenosis. <i>Conclusions:</i> Patients with extremely calcified LM lesions treated by PCI present a favorable prognosis if angioplasty is facilitated by more aggressive lesion debulking using calcium-dedicated devices. |
| first_indexed | 2024-03-11T03:31:21Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-11T03:31:21Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-79b01464619c4148908295d14b1271fe2023-11-18T02:20:43ZengMDPI AGMedicina1010-660X1648-91442023-04-0159582510.3390/medicina59050825Outcomes after Percutaneous Coronary Intervention in Patients with Extremely Calcified Left Main LesionsSilviu Dumitrascu0Daniela Bartos1Claudiu Ungureanu2Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bvd. Eroii Sanitari 8, 050474 Bucharest, RomaniaFaculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bvd. Eroii Sanitari 8, 050474 Bucharest, RomaniaCardiovascular Department, Jolimont Hospital, Ferrer St. 159, 7100 La Louviere, Belgium<i>Background and Objectives:</i> Available data with regard to the outcomes of patients with severely calcified left main (LM) lesions after revascularization by percutaneous coronary intervention (PCI) when compared to non-calcified LM lesions is unclear. <i>Materials and Methods:</i> The present study sought to retrospectively investigate in hospital and 1 year post-intervention outcomes of patients with extremely calcified LM lesions after PCI facilitated by calcium-dedicated devices (CdD). Seventy consecutive patients with LM PCI were included. CdD requirement was based on suboptimal results after balloon angioplasty. <i>Results:</i> Twenty-two patients (31.4%) required at least one CdD, while nine patients (12.8%) required at least two. Intravascular lithotripsy and rotational atherectomy were the predominantly used methods(59.1% and 40.9% respectively, for in-group ratios), while ultra-high pressure and scoring balloons contributed the least to lesion preparation (9%). In 20 patients (28.5%), severe or moderate calcifications were angiographically identified, but non-compliant balloon predilation was adequate and CdD were not necessary. Total procedural time was significantly higher in CdD group (<i>p</i>-value 0.02). Procedural and clinical success were obtained in 100% of cases. There were no major adverse cardiac and cerebrovascular events (MACCE) recorded during hospitalization. MACCE at 1 year post-procedure were recorded in three patients (4.2% overall). All three events were documented in the control group (6.2%), and no events were recorded in CdD group (<i>p</i>-value 0.23). There was one cardiac death at 10 months and two target lesion revascularizations for side-branch restenosis. <i>Conclusions:</i> Patients with extremely calcified LM lesions treated by PCI present a favorable prognosis if angioplasty is facilitated by more aggressive lesion debulking using calcium-dedicated devices.https://www.mdpi.com/1648-9144/59/5/825percutaneous left main revascularizationlesion preparationcalcified lesionsrotational atherectomyintracoronary lithotripsy |
| spellingShingle | Silviu Dumitrascu Daniela Bartos Claudiu Ungureanu Outcomes after Percutaneous Coronary Intervention in Patients with Extremely Calcified Left Main Lesions Medicina percutaneous left main revascularization lesion preparation calcified lesions rotational atherectomy intracoronary lithotripsy |
| title | Outcomes after Percutaneous Coronary Intervention in Patients with Extremely Calcified Left Main Lesions |
| title_full | Outcomes after Percutaneous Coronary Intervention in Patients with Extremely Calcified Left Main Lesions |
| title_fullStr | Outcomes after Percutaneous Coronary Intervention in Patients with Extremely Calcified Left Main Lesions |
| title_full_unstemmed | Outcomes after Percutaneous Coronary Intervention in Patients with Extremely Calcified Left Main Lesions |
| title_short | Outcomes after Percutaneous Coronary Intervention in Patients with Extremely Calcified Left Main Lesions |
| title_sort | outcomes after percutaneous coronary intervention in patients with extremely calcified left main lesions |
| topic | percutaneous left main revascularization lesion preparation calcified lesions rotational atherectomy intracoronary lithotripsy |
| url | https://www.mdpi.com/1648-9144/59/5/825 |
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