Author + information
- Wenjie Tian,
- Rebecca Torguson,
- Alfazir Omar,
- Hideaki Ota,
- Fang Cheng,
- Joshua Loh,
- Lakshmana Pendyala,
- Marco De Magalhaes Pereira,
- Nevin Baker,
- Ricardo Escarcega Alarcon,
- Saar Minha,
- Lowell Satler,
- Augusto Pichard and
- Ron Waksman
Limited information is available on the clinical outcome differences between rotational atherectomy (ROTA) and cutting balloon angioplasty (CA) followed by stents implantation.
Clinical data of 986 patients with native de novo coronary lesions who underwent ROTA (n=413) or CA (573) followed by stent implantation from 2003-2013 were retrospectively analyzed. The occurrence of major adverse cardiac events (MACE), defined as all-cause death, myocardial infarction (MI) or target lesion revascularization (TLR) were compared between the two groups at 6 months, 1 and 2 years.
Baseline clinical and procedural characteristics were similar between the two groups, except for greater age (71.7±10.6 vs. 67.6±11.2 years, p<0.01), higher prevalence of type C lesion (54.6% vs. 37.8%, p<0.01), greater length (20.8±6.5 vs. 18.9 ±6.6mm, p<0.01) and number of stents (1.7±1.0 vs. 1.4±0.9, p<0.01) in the ROTA group. The rate of procedure success (98.0% vs. 98.6%, p=0.516) and DES implantation (90.0% vs. 89.4%, p=0.659) were similar between two groups. There was no difference in MACE rate and occurrence of stent thrombus between the two groups (p=NS), however, higher all-cause death rate in the ROTA group at 6 months, 1 and 2 years (p<0.05).
ROTA was used in patients with more lesion complexity. However, the MACE rate was comparable between ROTA and CA at 6 months, 1 and 2 years.
|Clinical events||Cutting balloon (n=573)||Rotational atherectomy (n=413)||p value|
|All-cause death (%)||2.7||7.1||0.007|
|Definite ST (%)||0.5||1.1||0.654|
|All-cause death (%)||4.7||10.3||0.007|
|Definite ST (%)||0.6||1.0||0.655|
|Composite MACE (%)||10.6||14.5||0.145|
|All-cause death (%)||9.1||15.7||0.025|
|Definite ST (%)||0.7||1.4||0.655|
|Composite MACE (%)||18.2||22.8||0.205|
MI: Myocardial infarction; QWMI: Q-wave myocardial infarction; CABG: Coronary artery bypass grafting; TLR: Target lesion revascularization; ST: Stent thrombus; MACE: Major adverse cardiac events.