Rotational atherectomy in everyday clinical practice. Association of Cardiovascular Interventions of the Polish Society of Cardiology : Expert opinion
Rotational atherectomy in everyday clinical practice. Association of Cardiovascular Interventions of the Polish Society of Cardiology : Expert opinion
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DOI：
10.5603/kp.2018.0225
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发表时间：
2018-01-01
影响因子：
3.3
通讯作者：
Bartus, Stanislaw
中科院分区：
文献类型：
--
作者：
Dobrzycki, Slawomir;Reczuch, Krzysztof;Bartus, Stanislaw
支架的普遍使用，包括抗增殖药物洗脱支架，已经成为侵入性心脏病学的重大突破。目前，经皮冠状动脉介入治疗（PCI）患者的临床表现发生了变化。典型的临床特征包括高龄、糖尿病、慢性肾脏疾病、心力衰竭和多层面动脉粥样硬化。年龄、糖尿病和慢性肾脏疾病是冠状动脉钙化的主要预测因素。严重的冠状动脉钙化是限制PCI疗效的主要因素。在存在钙化的情况下，成功的支架植入具有挑战性，因为难以实现支架完全扩张和支架适当贴壁。因此，有必要在支架植入前充分准备病变。本文件介绍了旋切术（旋转消融）的技术以及手术的适应症和禁忌症，沿着其可能的并发症及其预防。还讨论了波兰对操作者的旋转消融培训以及手术的报销政策。
The common use of stents, including antiproliferative drug-eluting stents, has been a major breakthrough in invasive cardiology. Nowadays, a change in the clinical presentation of patients treated with percutaneous coronary intervention (PCI) is observed. The typical clinical characteristics now include advanced age, diabetes, chronic kidney disease, heart failure, and multilevel atherosclerosis. Age, diabetes, and chronic kidney disease are the main predictors of coronary artery calcifications. Severe coronary artery calcifications are the main factor limiting the efficacy of PCI. Successful stent implantation is challenging in the presence of calcifications, because it is difficult to achieve full stent expansion and proper stent apposition. Therefore, it is necessary to adequately prepare the lesion before stent implantation. This document presents the technique of rotational atherectomy (rotablation) as well as indications for and contraindications to the procedure, along with its possible complications and their prevention. Training in rotablation for operators as well as reimbursement policy for the procedure in Poland are also discussed.