Association of Excessive Speed Reduction with Clinical Factors During Rotational Atherectomy
Association of Excessive Speed Reduction with Clinical Factors During Rotational Atherectomy
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DOI：
10.1016/j.carrev.2019.05.014
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发表时间：
2020-03-01
影响因子：
1.7
通讯作者：
Fujita, Hideo
中科院分区：
文献类型：
--
作者：
Sakakura, Kenichi;Taniguchi, Yousuke;Fujita, Hideo
背景资料：尽管制造商建议在旋切术（RA）期间避免过度减速（>5000 rpm）以确保安全，但在临床实践中有时会观察到过度减速。本研究的目的是探讨与过度减速在RA。方法：病变（n = 300）治疗RA分为3组：轻度减速组（5000- 10000 rpm）（n = 21）。进行两个多变量逻辑回归分析以调查与>5000 rpm转速降低相关的因素和与> 10，000 rpm转速降低相关的因素。多因素Logistic回归分析显示，右冠状动脉（RCA）开口病变（OR 6.13，95% CI 1.82-20.70，P = 0.004）和总消融时间（每增加10 s：OR 1.09，95% CI 1.05-1.14，P < 0.001）与>5000 rpm转速降低显著相关。开口RCA病变（OR 14.17，95%CI 3.85-52.23，P < 0.001），使用主动脉内球囊反搏支持（OR 4.19，95%CI 1.18-14.87，P = 0.03），RA前收缩压（每增加10 mmHg：OR 1.25，95% CI 1.02-1.52，P = 0.03）与
Background: Although the manufacturer recommends that excessive speed reduction (>5000 rpm) be avoided during rotational atherectomy (RA) for safety, excessive speed reduction is sometimes observed in clinical practice. The purpose of the present study was to examine the factors associated with excessive speed reduction during RA.Methods: Lesions (n = 300) treated by RA were divided into 3 groups: a mild speed reduction group (5000-10,000 rpm) (n = 21). Two multivariate logistic regression analyses was performed to investigate the factors associated with >5000 rpm speed reduction, and factors associated with >10,000 rpm speed reduction.Results: Multivariate logistic regression analysis revealed that an ostial right coronary artery (RCA) lesion (OR 6.13, 95% CI 1.82-20.70, P = 0.004) and total ablation time (every 10 s increase: OR 1.09, 95% CI 1.05-1.14, P < 0.001) were significantly associated with >5000 rpm speed reduction. An ostial RCA lesion (OR 14.17, 95% CI 3.85-52.23, P < 0.001), use of intra-aortic balloon pump support (OR 4.19, 95% CI 1.18-14.87, P = 0.03), and systolic blood pressure just before RA (every 10 mmHg increase: OR 1.25, 95% CI 1.02-1.52, P = 0.03) were significantly associated with