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Treatment of calcified lesions with balloon angioplasty has been associated with a low success rate and high procedural complications. Rotational atherectomy (RA) improved acute results, but a high restenosis rate remained a problem. Therefore, the purpose of this study was to evaluate the clinical and angiographic outcome of patients with complex and calcified lesions treated with a combination of RA and second-generation drug-eluting stent (DES) implantation.
Consecutive 55 patients received combination therapy of RA and second-generation DES implantation at de novo lesion of native coronary artery with severe calcification between June 2009 and December 2012. Zotarolimus-eluting stents (ZES), biolimus-eluting stent (BES), and everolimus-eluting stents (EES) were used in 14, 7, and 34 patients, respectively. 39 patients (ZES, BES, and EES were used in 12, 6, 21 patients) received one-year follow-up angiography. The clinical and angiographic outcome was compared among those 3 groups of different DES.
Only one patient was dead (a cause was unknown). Target lesion revascularization (TLR) rate was 0% among 3 groups. The late loss was larger in ZES than in BES or EES (ZES vs. BES vs. EES: 0.37±0.20mm vs. 0.20±0.10mm vs. 0.16±0.15mm, p<0.05).
The clinical outcome of 3 second-generation DES used in combination with RA was very good, although the culprit lesions were complex with severe calcification. Combination therapy of RA and second-generation DES appeared acceptable.