Comparison of clinical outcomes of intravascular ultrasound-calcified nodule between percutaneous coronary intervention with versus without rotational atherectomy in a propensity-score matched analysis.
Comparison of clinical outcomes of intravascular ultrasound-calcified nodule between percutaneous coronary intervention with versus without rotational atherectomy in a propensity-score matched analysis.
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DOI：
10.1371/journal.pone.0241836
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发表时间：
2020
期刊：
影响因子：
3.7
通讯作者：
Fujita H
中科院分区：
文献类型：
--
作者：
Watanabe Y;Sakakura K;Taniguchi Y;Yamamoto K;Seguchi M;Tsukui T;Jinnouchi H;Wada H;Momomura SI;Fujita H
本研究旨在比较血管内超声(IVUS)钙化结节在经皮冠状动脉介入治疗(PCI)加和不加旋切(RA)治疗中的中期临床结果。对于是否使用RA进行钙化结节的血运重建一直存在争议。虽然RA可以消融钙化结节内的钙化结构，并可能促进支架的充分扩张，但RA可能会引发严重的冠状动脉穿孔，因为钙化结节通常表现为偏心性钙化。包括204个IVUS钙化结节，分为RA治疗组(RA组)73个和非RA治疗组(Non-RA组)131个。经倾向性评分匹配后，选取42个RA病变(匹配RA组)和42个非RA病变(匹配非RA组)。我们比较了两组在倾向-分数匹配前后的临床特征和结果。主要终点是1年内的缺血驱动靶血管再血管化(TVR)。匹配的RA组和匹配的非RA组的IVUS急性管腔面积增大相似(3.9±2.1mm2比3.4±1.6mm2，p=0.18)。两组均可见钙化结节内支架错位。两组在倾向评分匹配前(p=0.82)和倾向评分匹配后(p=0.87)，缺血驱动的TVR差异无统计学意义。在IVUS钙化结节的病变中，RA的使用不能减少缺血驱动的TVR的发生率。我们的结果不支持常规使用RA治疗IVUS钙化结节的病变。
This study aimed to compare the mid-term clinical outcomes of intravascular ultrasound (IVUS)-calcified nodules between percutaneous coronary intervention (PCI) with and without rotational atherectomy (RA). There has been a debate whether to use RA for the revascularization of calcified nodule. Although RA can ablate the calcified structure within calcified nodule and may facilitate adequate stent expansion, RA may provoke severe coronary perforation, because calcified nodule typically shows eccentric calcification. We included 204 lesions with IVUS-calcified nodule, and divided into 73 lesions treated with RA (RA group) and 131 lesions without RA (non-RA group). After propensity-score matching, 42 lesions with RA (matched RA group) and 42 lesions without RA (matched non-RA group) were selected. We compared the clinical characteristics and outcomes between the 2 groups before and after propensity-score matching. The primary endpoint was ischemia-driven target vessel revascularization (TVR) within 1 year. Acute lumen area gain on IVUS was comparable between the matched RA group and matched non-RA group (3.9 ± 2.1 mm2 vs. 3.4 ± 1.6 mm2, p = 0.18). The stent malapposition at calcified nodules was frequently observed in both groups. The ischemia-driven TVR was not different between the 2 groups before (p = 0.82) and after propensity score-matching (p = 0.87). The use of RA could not reduce the incidence of ischemia-driven TVR in lesions with IVUS-calcified nodule. Our results do not support the routine use of RA for lesions with IVUS-calcified nodule.
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DOI：
10.1016/s0735-1097(01)01175-5
发表时间：
2001-04-01
影响因子：
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作者：
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DOI：
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影响因子：
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