Clinical outcomes of PCI with rotational atherectomy: the European multicentre Euro4C registry

Bouisset, Frédéric; Barbato, Emanuele; Reczuch, Krzysztof; Dobrzycki, Sławomir; Meyer‐Geßner, Markus; Bressollette, Erwan; Cayla, Guillaume; Lhermusier, Thibault; Zajdel, Wojciech; Molinero, Jorge Palazuelos; Ferenc, Mirosław; Ribichini, Flavio; Carrié, Didier

doi:10.4244/eij-d-19-01129

Cited by 30 publications

(29 citation statements)

References 23 publications

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“…Diabetes itself might be an individual predictor of periprocedural complications during RA [20]. ACS was presented as an individual risk factor for major adverse cardiovascular events during RA procedures in similar studies [21,22].…”

Section: Discussionmentioning

confidence: 98%

Sex-related differences and rotational atherectomy: Analysis of 5 177 percutaneous coronary interventions based on a large national registry from 2014 to 2020

Sabatowski¹,

Malinowski

Siudak

et al. 2021

Kardiol Pol

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Background: Patients undergoing percutaneous coronary interventions (PCI) with rotational atherectomy (RA) have massively calcified coronary arteries and their prognosis differs between sexes. Aims:The aim of the study was to evaluate the trends in the percentage of sexes in the subsequent years, to compare demographic characteristics between men and women, and to identify factors associated with the risk of periprocedural complications and death. Methods:We analyzed data on 751 113 patients treated with PCI between 2014 and 2020 from the Polish National Registry of Percutaneous Coronary Interventions (ORPKI). We extracted data on 5 177 (0.7%) patients treated with RA of whom 3 552 (68.6%) were men. To determine risk factors of periprocedural complications and death, a multivariable analysis was performed. Results:The proportion of PCIs involving RA increased between 2014 and 2020 (P <0.001). Almost twice as many RA procedures were performed on men (68.55%), and that proportion did not change in the following years. The female patients were older (75.2 [8.3] vs. 70.5 [9.2] years; P <0.001). When considering periprocedural complications, their overall rate (3.45% vs. 2.31%; P = 0.01) and death rate (0.68% vs. 0.17%; P = 0.006) were greater among women. Also, via multivariable analysis, female sex was found to be a risk factor for greater periprocedural mortality (P = 0.02) and overall complication rate (P = 0.007). 1321 Karol Sabatowski et al., Rotational atherectomy and sex w w w . j o u r n a l s . v i a m e d i c a . p l / k a r d i o l o g i a _ p o l s k a W H a t ' S n e W ?Female sex is associated with poorer clinical outcomes after percutaneous coronary interventions (Pcis) including a higher risk of death, myocardial infarction or target vessel failure, and lesion failure in long-term follow-up. Patients undergoing Pci with rotational atherectomy (ra) have massively calcified coronary arteries and differ according to sex. We aimed to assess the trends in the percentage of sexes in the years 2014-2020, to compare demographic characteristics between men and women and to identify factors associated with the risk of periprocedural complications and death. Out of 751 113 patients treated with Pci between 2014 and 2020, we extracted data on 5 177 (0.7%) patients treated with ra of whom 3 552 (68.6%) were men. Sex-related distribution of patients treated with ra was stable during the analyzed period. Multivariable regression analysis confirmed that female sex is a risk factor of periprocedural complications and mortality in patients treated with Pci and ra.

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Section: Discussionmentioning

confidence: 98%

Sex-related differences and rotational atherectomy: Analysis of 5 177 percutaneous coronary interventions based on a large national registry from 2014 to 2020

Sabatowski¹,

Malinowski

Siudak

et al. 2021

Kardiol Pol

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“…This probably reflects a revived interest in atherectomy in the last decade due to increasing lesion complexity. 2 Bouisset et al 3 showed that rotational atherectomy was associated with high clinical success (91.6%) and an acceptable major adverse cardiovascular event rate of 4.7%.…”

Section: Discussionmentioning

confidence: 99%

Learning and innovation among interventional cardiologists: Insights from an international survey

Vemmou

Nikolakopoulos

Xenogiannis

et al. 2021

Cathet Cardio Intervent

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Background: The willingness of interventional cardiologists to adopt innovation and implement changes in day-to-day practice has received limited study. Methods:Online-based survey on learning and innovation: 38 questions were distributed via email list to interventional cardiologists. Results:The survey was distributed to 8,110 e-mails and completed by 621 (7.7%, 91.8% men, 60% in the 35 to 54-year-old age group). Of the respondents who perform coronary interventions, 45% perform >100 cases of noncomplex percutaneous coronary interventions per year and of the respondents who perform structural interventions, 15% perform more than >100 transcatheter aortic valve replacements per year. Most respondents (86.7%) rate themselves as highly likely/likely to introduce recently approved equipment in everyday practice and 47.5% have tried a new coronary guidewire in the past 6 months. The most common reasons for reluctance to use new equipment were high cost (64%) and uncertainty about whether it provides additional benefits compared with existing equipment (48.5%). Radial access in STEMI cases is always used by 43.6% of the respondents and 55% always use radial access for coronary angiography. Of those who use femoral access, 32% always use ultrasound guidance and 91% have used a closure device in the last 6 months. Most respondents (80%) read journals to keep up with current practice and believe that the most effective way to learn is through attendance of workshops/short courses (77.5%). Most respondents (69%) are involved in research. Conclusion:Interventional cardiologists who participated in the survey are highly likely to adopt innovation in daily clinical practice.

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“… 12 Our results also were compared well to clinical success rates (defined as residual stenosis <50% and no periprocedural complications) for rotablation in a large (966 patients) contemporary European registry (91.9%). 13 Utilizing intracoronary imaging, our results establish the efficacy of IVL in treating highly calcified coronary lesions in a range of real‐world patients (Figure 2 ), comprising many lesions (eg, LMS, ISR, unstable lesions in ACS) that were not included in the original DISRUPT‐CAD trials of IVL. 4 , 14 Furthermore, we have demonstrated the calcium fracturing effect of IVL on intracoronary calcium on three different intravascular imaging modalities, confirming early OCT studies that showed circumferential modification of calcium.…”

Section: Discussionmentioning

confidence: 64%

Intravascular imaging–guided intracoronary lithotripsy: First real‐world experience

Sinclair

Fan

Fahy

et al. 2021

Health Science Reports

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Background and Aims Coronary calcification remains a significant challenge for the contemporary interventional cardiologist. We aim to describe the use of intravascular lithotripsy (IVL) in a range of real‐world settings. Methods A retrospective two‐center analysis of patients treated with IVL between June 2018 and November 2019. Technical and procedural success, as well as procedural complications and 30‐day outcomes (death, myocardial infarction, or repeat target vessel revascularization), was recorded. Results Sixty‐five patients underwent IVL: 80% were male and the mean age was 70.1 ± 12.0 years. 54% of patients presented with acute coronary syndrome (ACS) and 68% of patients had intracoronary imaging. Twelve patients required IVL within pre‐existing stents, and 12 underwent IVL in the left main stem. All balloons were successfully delivered with 98.5% procedural success. There was a significant gain in MLA post PCI of 261.9 ± 100% following IVL. There were two procedural complications. At 30‐day follow‐up, there was one death, and one patient required a repeat procedure due to stent underexpansion. Conclusions In this largest real‐world series of imaging‐guided IVL for calcified lesions to date, we demonstrate that IVL is deliverable, safe, and effective at calcium modification especially when intracoronary imaging is used.

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Clinical outcomes of PCI with rotational atherectomy: the European multicentre Euro4C registry

Cited by 30 publications

References 23 publications

Sex-related differences and rotational atherectomy: Analysis of 5 177 percutaneous coronary interventions based on a large national registry from 2014 to 2020

Sex-related differences and rotational atherectomy: Analysis of 5 177 percutaneous coronary interventions based on a large national registry from 2014 to 2020

Learning and innovation among interventional cardiologists: Insights from an international survey

Intravascular imaging–guided intracoronary lithotripsy: First real‐world experience

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