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    Utility of rotational atherectomy and outcomes over an eight-year period

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    Authors
    Couper, L.
    Loane, P.
    Andrianopoulos, N.
    Brennan, A.
    Nanayakkara, S.
    Nerlekar, N.
    Scott, P.
    Walton, A.
    Clark, D.
    Duffy, S.
    Ajani, A.
    Reid, Christopher
    Shaw, J.
    Date
    2015
    Type
    Journal Article
    
    Metadata
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    Citation
    Couper, L. and Loane, P. and Andrianopoulos, N. and Brennan, A. and Nanayakkara, S. and Nerlekar, N. and Scott, P. et al. 2015. Utility of rotational atherectomy and outcomes over an eight-year period. Catheterization and Cardiovascular Interventions. 86 (4): pp. 626-631.
    Source Title
    Catheterization and Cardiovascular Interventions
    DOI
    10.1002/ccd.26077
    ISSN
    1522-1946
    School
    Department of Health Policy and Management
    URI
    http://hdl.handle.net/20.500.11937/19796
    Collection
    • Curtin Research Publications
    Abstract

    Objectives: To evaluate outcomes of patients undergoing rotational atherectomy (RA) in a multicenter percutaneous coronary intervention (PCI) registry. Background: RA remains an important technique for plaque modification in PCI, particularly with complex calcification. Methods: The study population consisted of consecutive patients undergoing PCI in nine major Australian hospitals, who were treated over an 8-year period (June 2004 to June 2012). Results: Of 16,577 PCI's, 1.0% of patients n=167 (214 lesions) underwent RA. Patients undergoing RA were more likely to be older (71.0±9.7 vs. 64.4 ±11.9 years, P<0.01), with greater incidence of diabetes (37.7% vs. 23.8%, P<0.01) and renal impairment. There was no significant difference in procedural success (94.6% vs. 95.5%, P=0.57), dissection (6.1% vs. 4.8%, P=0.39), transient no reflow (4.4% vs. 2.8%, P=0.23), or persistent no reflow (0% RA vs. 0.7% non-RA, P=0.23). Those undergoing RA had a low but increased risk of death at 12 months (6.6 vs. 3.6%, P=0.04). There was no significant difference in 12 month major adverse cardiovascular outcomes (MACE) between groups following adjustment for univariate predictors (OR 1.00, 95%CI; 0.93-1.08). Additionally, there was no significant difference in 30-day MACE (6.0% vs. 5.1%, P=0.62) or 30-day mortality (2.4% vs. 1.8%, P=0.54) between groups. Conclusions: In this large multicenter registry, RA continues to be used to treat complex lesions with low procedural complications and MACE rates. It is essential for interventional cardiologists to maintain skills in RA to enable effective percutaneous treatment of certain complex lesions.

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