Long-term outcomes of rotational atherectomy of underexpanded stents. A single center experience
Long-term outcomes of rotational atherectomy of underexpanded stents. A single center experience
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DOI：
10.1111/joic.12491
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发表时间：
2018-08-01
影响因子：
2.1
通讯作者：
Boudou, Nicolas
中科院分区：
文献类型：
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作者：
Hernandez-Enriquez, Marco;Campelo-Parada, Francisco;Boudou, Nicolas
目的 分析在我们的队列中使用旋磨术 (RA) 治疗扩张不足的支架的手术和长期结果，并概述该技术的当前可用数据。背景支架扩张不足 (SU) 与支架血栓形成和再狭窄有关。 RA 已被用来治疗不可扩张的 SU，作为一种缓解策略，取得了令人鼓舞的结果。方法这是一项观察性、单中心研究。我们纳入了 2013 年至 2017 年间接受支架置入术的患者。回顾性收集了基线人口统计学、手术结果、院内主要不良心脏事件 (MACE) 和长期随访 MACE。结果 本研究共纳入 11 例患者（90.9% 男性，平均年龄 65.418.6）。左心室射血分数中位数为 53.5% [46.2-55]。计算的 Syntax 评分中位数为 16 [9-31]，45.5% 的患者因急性冠状动脉综合征入院。 63.6% 的病例采用径向入路。大多数患者在干预期间只需要一根毛刺（45% 使用直径 1.5 毫米的毛刺）。 90.9%的案件取得了手术成功。急性流明增益为 42.7% [30.7-61.49]。没有发生院内死亡或 MACE。在中位随访 26 个月时，只有 1 名患者 (9.1%) 在急性冠状动脉综合征的情况下出现 MACE，另外 2 名患者 (18.2%) 需要进行非靶病变血运重建。没有死亡报告。结论 扩张不足的支架的 RA 是一种可行的选择，手术成功率很高。在长期随访中，所有患者均存活，并且 90.9% 的患者未发生 MACE。
ObjectivesTo analyze the procedural and long-term outcomes of the use of rotational atherectomy (RA) in underexpanded stents in our cohort and to provide an overview of currently available data on this technique.BackgroundStent underexpansion (SU) has been related to stent thrombosis and restenosis. RA has been used to treat undilatable SU as a bail-out strategy with encouraging results.MethodsThis is an observational, single-center study. We included patients who underwent stentablation between 2013 and 2017. Baseline demographics, procedural results, in-hospital major adverse cardiac events (MACE), and long-term follow-up MACE were retrospectively collected.ResultsA total of 11 patients (90.9% males, mean age 65.418.6) were included in this study. Median left ventricle ejection fraction was 53.5% [46.2-55]. Median calculated Syntax score was 16 [9-31] and 45.5% of patients were admitted for acute coronary syndrome. Radial approach was used in 63.6% of cases. Most patients only required one burr (45% used a 1.5mm diameter burr) during the intervention. Procedural success was achieved in 90.9% of the cases. Acute lumen gain was 42.7% [30.7-61.49]. There were no in-hospital deaths or MACE. At a median follow-up of 26 months, only one patient (9.1%) suffered MACE in the context of acute coronary syndrome, and two patients (18.2%) required non-target lesion revascularization. No deaths were reported.ConclusionsRA of under expanded stents is a feasible option with a high rate of procedural success. At long-term follow-up, all of them were alive and 90.9% of patients remained free from MACE.