Percutaneous coronary intervention with rotational atherectomy for severely calcified unprotected left main: Immediate and two‐years follow‐up results

Abstract

In a group of high surgical risk patients, RA on severely calcified left main stenosis is feasible and, in spite of high mortality rates, could pose the only possible effective treatment.

High-speed rotational atherectomy of the left main coronary artery: a single-center experience in 50 high-risk patients

“…The previously published experience with rotablation of the LM is summarized in Table 5. Our results can be compared with a recent report of Garcia-Lara and co-workers reporting their experience of 40 LM rotablation procedures with a two-year cardiac mortality of 29% and a TVR rate of 19.3% [16]. Both patient cohorts had similar characteristics as assessed by the SYNTAX and EuroSCOREs.…”

“…Notably, patients with LM disease were excluded from the recently published randomized ROTAXUS trial, and only limited data about RA of the LM are available in the current literature [15][16][17][18][19]. We therefore present our experience with RA of LM coronary artery disease in 50 patients with high surgical risk because of comorbidities and highly complex mostly calcified lesions.…”

Impact of Rotational Atherectomy on Heavily Calcified, Unprotected Left Main Disease

“…17 PCI using Rota for LM lesions was reported to be feasible despite the high hospital mortality rate (7.5%). 10 In the present study, the in-hospital mortality rate was 0% and the 30-day mortality rate was 3.1%; the latter was because of ST in 2 patients. In general, patients with severely calcified lesions are at a very high risk and have a poor prognosis in the short and medium terms.…”

Incidence and Determinants of Complications in Rotational Atherectomy

“…Number of diseased vessels, especially left main disease, was the significant determinant of the composite outcome. Although several groups reported the acceptable clinical outcomes after RA to the unprotected left main stenosis, [19][20][21] it does not mean that RA to unprotected left main stenosis is as safe as RA to other lesions. Furthermore, the use of circulatory support devices, such as intra-aortic balloon pump or Impella (Abiomed Inc, Danvers, MA), may reduce the incidence of severe complications even in high-risk RA patients, such as those with left main disease or left ventricular dysfunction.…”