HIGH-SPEED ROTATIONAL ATHERECTOMY - OUTCOME IN CALCIFIED AND NONCALCIFIED CORONARY-ARTERY LESIONS
HIGH-SPEED ROTATIONAL ATHERECTOMY - OUTCOME IN CALCIFIED AND NONCALCIFIED CORONARY-ARTERY LESIONS
复制标题
DOI：
10.1016/0735-1097(95)00206-j
复制
发表时间：
1995-09-01
影响因子：
24
通讯作者：
WHITLOW, PL
中科院分区：
文献类型：
--
作者：
MACISAAC, AI;BASS, TA;WHITLOW, PL
目标.本研究旨在确定钙化和非钙化病变中高速旋转冠状动脉粥样硬化斑块切除术的成功率和并发症发生率。钙化病变的经皮腔内冠状动脉成形术和定向冠状动脉粥样斑块旋切术与手术成功率降低和并发症增加相关。使用Rotablator导管进行的旋切术可磨除非顺应性斑块，并可能改善钙化病变的结局。对2,161例单处病变旋切术的已完成多中心Rotablator登记研究的数据进行了分析，以确定旋切术对1,078例钙化病变和1,083例非钙化病变的相对有效性。如果非钙化和钙化病变的真实成功率分别为96%和93%，则该研究的功效为0.86，以检测结果的显著差异。钙化病变患者年龄大于非钙化病变患者（平均[+/-SD]年龄66.2 ± 10.3岁vs 60.5 ± 11.0岁，p = 0.0001）。钙化病变更常见于新发病变（75% vs. 64%，p = 0.0001）、成角病变（27% vs. 22%，p = 0.02）和偏心病变。(75% vs. 64%，p = 0.0001）和长（32% vs. 27%，长度>10 mm，p = 0.01）。它们也更常见复杂（57% vs. 46%，p = 0.001），位于冠状动脉左前降支（51% vs. 44%，p = 0.001）。82.9%的钙化病变和66.9%的非钙化病变采用辅助冠状动脉成形术。手术成功，定义为
Objectives. This study sought to determine the success and complication rates of high speed rotational coronary atherectomy in calcified and noncalcified lesions.Background. Percutaneous transluminal coronary angioplasty and directional coronary atherectomy of calcified lesions are associated with reduced procedural success and increased complications. Rotational atherectomy using the Rotablator catheter abrades noncompliant plaque and may improve outcome in calcified lesions.Methods. Data from the completed Multicenter Rotablator Registry of 2,161 rotational atherectomy procedures in single lesions were analyzed to determine the relative efficacy of rotational atherectomy for 1,078 calcified and 1,083 noncalcified lesions. The power of the study was 0.86 to detect a significant difference in outcome, if the true success rates in the noncalcified and calcified lesions were 96% and 93%, respectively.Results. Patients with calcified lesions were older (mean [+/-SD] age 66.2 +/- 10.3 vs, 60.5 +/- 11.0 years, p = 0.0001) than those with noncalcified lesions. Calcified lesions were more frequently new (75% vs. 64%, p = 0.0001), angulated (27% vs. 22%, p = 0.02), eccentric.(75% vs. 64%, p = 0.0001) and long (32% vs. 27%, >10 mm in length, p = 0.01). They were also more often complex (57% vs. 46%, p = 0.001) and located in the left anterior descending coronary artery (51% vs. 44%, p = 0.001). Adjunctive coronary angioplasty was used in 82.9% of calcified and 66.9% of noncalcified lesions. Procedural success, defined as