Percutaneous Coronary Intervention in Heavily Calcified Lesions Using Rotational Atherectomy and Paclitaxel-Eluting Stents: Outcomes at One Year

Long‐term clinical outcome of rotational atherectomy followed by drug‐eluting stent implantation in complex calcified coronary lesions

“…In the present study, a TVR rate of 9.9% and a TLR rate of 6.8% at 15 months indicate an excellent long‐term result, which is in line with other reports. Khattab et al, Furuichi et al, and Garcia de Lara et al reported small observational studies with RA and DES and documented TLR rates between 6.2 and 9.5%. Rathore et al have so far published the largest cohort of 391 Rota‐DES patients with a 70% follow‐up at 6–9 months.…”

“…The contention that RA induces additional vessel trauma with a consecutive increase in neointima formation made RA a niche modality preserved for otherwise untreatable lesions, especially in severely calcified anatomies . Recently, some observational studies suggested a favorable long‐term outcome of RA followed by drug‐eluting stent (DES) implantation (Rota‐DES) . Reintervention rates in the one digit range have been reported, which are substantially lower than restenosis rates after RA as a stand‐alone procedure or after rotastenting with bare‐metal stents .…”

Comparison of drug-eluting versus bare-metal stents after rotational atherectomy for the treatment of calcified coronary lesions

“…However, relatively high rates of adverse events including malign ventricular arrhythmias and mortality were previously reported in some series [5]. in these patients [7]. Interestingly, in a recently published study comprising patients with TTC, left or right ventricular (LV or RV) contraction patterns in the setting of disease course were not found to be associated with mortality and clinical presentation, etc.…”

“…Even though the exact mechanisms of adverse events during the disease course have yet remained to be established, neuropeptide-Y (NPY) (a vasoconstrictor hormone) induced severe coronary microvascular dysfunction was previously suggested to account for lifethreatening conditions including ischemic malign arrhythmic events in patients with TTC [6]. In general, TTC has been suggested as a form of acute heart failure syndromes [7] triggered by robust and acute increases in the endogenous stress levels. in these patients [7].…”

Evaluation of the Diamondback 360 Coronary Orbital Atherectomy System for treatingde novo, severely calcified lesions

“…Extensive calcium may also damage the DES polymer coating [32,33] and therefore contribute to the ineffectiveness of DES [34]. Additionally, given the difficulty in treating calcific coronary lesions percutaneously, patients may be referred for coronary artery bypass surgery (CABG).…”