Halfway rotational atherectomy for calcified lesions: Comparison with conventional rotational atherectomy in a propensity-score matched analysis
Halfway rotational atherectomy for calcified lesions: Comparison with conventional rotational atherectomy in a propensity-score matched analysis
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DOI：
10.1371/journal.pone.0219289
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发表时间：
2019-07-05
期刊：
影响因子：
3.7
通讯作者：
Fujita, Hideo
中科院分区：
文献类型：
--
作者：
Sakakura, Kenichi;Taniguchi, Yousuke;Fujita, Hideo
背景旋磨术（RA）中严重并发症（例如毛刺卡压或穿孔）的发生率相当高。 Halfway RA是一种新颖的策略，操作者不会将毛刺推进到连续钙化病变的末端，而是进行球囊扩张以治疗钙化病变的剩余部分。本研究的目的是比较半程 RA 和常规 RA 后的并发症。方法我们纳入了 307 个连续病变，分为常规 RA 组 (n = 244) 和半程 RA 组 (n = 63)。在分析1中，比较了常规RA组和半程RA组的并发症发生率。使用倾向评分匹配来匹配有意的半途 RA 和常规 RA。分析2比较匹配的常规RA组和有意中途RA组的并发症发生率。结果常规RA组出现毛刺卡压（0.4%）和严重穿孔（0.8%），而中途RA组未出现毛刺卡压或穿孔。半程RA的成功率为90.5%，需要从半程RA转为常规RA。有意中途RA组和匹配的常规RA组之间慢血流和慢血流围手术期心肌梗死的发生率相似。结论中途RA后没有毛刺卡压或血管穿孔。有意性半程 RA 与匹配的常规 RA 之间慢血流和围手术期心肌梗死的发生率相似，表明半程 RA 的安全性。
BackgroundThe incidence of severe complications such as burr entrapment or perforation is considerable with rotational atherectomy (RA). Halfway RA is a novel strategy, in which an operator does not advance the burr to the end of a continuous calcified lesion, and performs balloon dilatation to treat the remaining part of the calcified lesion. The purpose of this study was to compare complications after halfway and conventional RA.MethodsWe included 307 consecutive lesions that were divided into a conventional RA group (n = 244) and halfway RA group (n = 63). In analysis 1, the incidence of complications was compared between the conventional RA and halfway RA groups. Propensity-score matching was used to match the intentional halfway RA and conventional RA. In analysis 2, the incidence of complications was compared between the matched conventional RA and intentional halfway RA groups.ResultsBurr entrapment (0.4%) and major perforation (0.8%) were observed in the conventional RA group, whereas there was no burr entrapment or perforation in the halfway RA group. The success rate of halfway RA was 90.5%, which required switching from halfway RA to conventional RA. The incidences of slow flow and periprocedural myocardial infarction with slow flow were similar between the intentional halfway RA and matched conventional RA groups.ConclusionsThere was no burr entrapment or vessel perforation following halfway RA. The incidences of slow flow and periprocedural myocardial infarction were similar between the intentional halfway RA and the matched conventional RA, indicating the safety of halfway RA.