Outcome of narrowing related side branches after high-speed rotational atherectomy

Walton, Antony; Pomerantsev, Eugene; Oesterle, Stephen N.; Yeung, Alan C.; Singer, Alan H.; Shaw, Richard E.; Stertzer, Simon H.

doi:10.1016/s0002-9149(97)89366-6

Cited by 15 publications

(7 citation statements)

References 14 publications

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“…Cardiac complications of RA have been a matter of concern, because they are potentially life threatening. In the 1990s, several studies showed relatively high complication rates after RA (coronary perforation, 0-1%; urgent CABG, 1-3%; RA-related mortality, 0-3%) [38][39][40]. In recent studies in the 2010s, these complications were reduced (coronary perforation, 0.0-2.0%; urgent CABG, 0.0-0.8%; RA-related mortality, 0.0-1.7%) by using advanced procedural techniques for RA, such as lower rotational speeds, minimization of speed drops, and intermittent lesion contact [7,[20][21][22][23][24][25][26][27][28].…”

Section: Cardiac Complications Of Ramentioning

confidence: 99%

Relationship between hospital volume and major cardiac complications of rotational atherectomy: A nationwide retrospective cohort study in Japan

Isogai

Yasunaga

Matsui

et al. 2016

Journal of Cardiology

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Section: Cardiac Complications Of Ramentioning

confidence: 99%

Relationship between hospital volume and major cardiac complications of rotational atherectomy: A nationwide retrospective cohort study in Japan

Isogai

Yasunaga

Matsui

et al. 2016

Journal of Cardiology

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“…It has been proposed that RA can be performed safely in vessels containing significant side branches [45,46]. The incidence of sidebranch occlusion with the use of RA has ranged widely from 1.5% to 7.5% (Table VI), but with high procedural success in the range of 95-100%, and is additionally associated with decreased incidence of side-branch occlusion perhaps due to less plaque shift ("snow plow" effect).…”

Section: Bifurcation Lesionsmentioning

confidence: 99%

Current status of rotational atherectomy

Çavuşoğlu¹,

Kini²,

Marmur³

et al. 2004

Cathet Cardio Intervent

114

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Despite the increasing use of percutaneous transluminal coronary angioplasty and intracoronary stent placement for the treatment of obstructive coronary artery disease, a large subset of coronary lesions cannot be adequately treated with balloon angioplasty and/or intracoronary stenting alone. Such lesions are often heavily calcified or fibrotic and undilatable with the present balloon technology and attempts to treat them with balloon angioplasty or intracoronary stent placement often lead to vessel dissection or incomplete stent deployment with resultant adverse outcomes. Rotational atherectomy remains a useful niche device for the percutaneous treatment of such complex lesions, usually as an adjunct to subsequent balloon angioplasty and/or intracoronary stent placement. In contrast to balloon angioplasty or stent placement that widen the coronary lumen by displacing atherosclerotic plaque, rotational atherectomy removes plaque by ablating the atherosclerotic material, which is dispersed into the distal coronary circulation. Other lesion subtypes amenable to treatment with this modality include ostial and branch-ostial lesions, chronic total occlusions, and in-stent restenosis. This review discusses the technique and principles of rotational atherectomy, the various treatment strategies for its use (including adjunctive pharmacotherapy), the lesion-specific applications for this device, and the complications unique to this modality. Recommendations are also made for its use in the current interventional era.

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“…An important limitation of stenting is a possible risk of side branch occlusion (SBO), however, described in up to 18% of patients after stenting [1][2][3][4][5]. Although it may be tolerable for small side branches, occlusion of large side branches may give rise to angina or myocardial infarction.…”

Section: Introductionmentioning

confidence: 99%

Effects of stent design on side branch occlusion after coronary stent placement

Cho

Lee

Hong

et al. 2001

Cathet Cardio Intervent

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This study was performed to assess the immediate and long-term patency of stent-associated side branches (SB) according to the types of stent. A total of 314 patients with 332 lesions (CrossFlex stent 86, NIR 100, GFX 146) had 365 SB (>1 mm) covered by coronary stents. Side branch occlusion (SBO) occurred in 7.7% of CrossFlex stent, in 10.5% of NIR stent and in 8.8% of GFX stent (P = NS). SBO primarily occurred in SB with ostial disease, and the presence of SB ostial disease was the only independent predictors of SBO after stenting (OR 22.1, 95% CI 9.47-51.49, P < 0.001). At 6 months follow-up, 11 of 31 SBO regained the patency, but the remaining SB had persistent SBO. Delayed SBO occurred in 8 SB, being associated with the presence of SB ostial disease and in-stent restenosis. In conclusions, SBO was not associated with the types of stent design, but with the SB lesion morphology.

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Outcome of narrowing related side branches after high-speed rotational atherectomy

Cited by 15 publications

References 14 publications

Relationship between hospital volume and major cardiac complications of rotational atherectomy: A nationwide retrospective cohort study in Japan

Relationship between hospital volume and major cardiac complications of rotational atherectomy: A nationwide retrospective cohort study in Japan

Current status of rotational atherectomy

Effects of stent design on side branch occlusion after coronary stent placement

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