Author + information
- Wenjie Tian,
- Rebecca Torguson,
- Nevin Baker,
- Thibault Lhermusier,
- Hideaki Ota,
- Sarkis Kiramijyan,
- Smita Negi and
- Eddie Koifman
This study aimed to compare the outcome following plain old balloon angioplasty (POBA), cutting balloon angioplasty (CBA) and rotational atherectomy (ROTA) in patients with heavily calcified coronary lesions (HCCL).
Clinical data of the patients with HCCL who underwent POBA (n=220), CBA (n=253), or ROTA (n=264) prior to DES 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 at one year follow-up.
Baseline clinical characteristics were similar among the three groups, except for older patients age, and type C lesions in the ROTA versus the CBA and POBA (71.9±10.4 vs. 68.0±10.8, 68.7±11.8 years, p<0.001), and (61.7% vs. 35.8%, 45.0%, p<0.001) respectively. Angiographic success was achieved in all patients. At one year follow-up, the MACE rate was similar (14.6% in the ROTA group, 12.3% in the POBA group and 8.3% in the CBA group, p=0.204). The occurrence of stent thrombosis was 0.6% in the CBA and 0% in the ROTA and POBA group.
In patients with HCCL, ROTA was frequently used for the treatment of more complex lesions compared with CBA and POBA. The different strategies with ROTA, CBA and POBA prior to DES implantation resulted in the similar long-term outcomes after optimal lesion preparation for patients with HCCL.
|Variable||POBA (n=220)||CBA (n=253)||ROTA (n=264)||p value|
|6 month follow-up (%)|
|All cause death||6.2||2.2||6.3||0.135|
|1 year follow-up (%)|
|All cause death||8.2||4.5||9.8||0.178|
MACE: Major adverse cardiac events; MI: Myocardial infarction; TLR: Target lesion revascularization