Thin-strut drug-eluting stents are more favorable for severe calcified lesions after rotational atherectomy than thick-strut drug-eluting stents.
نویسندگان
چکیده
AIM Percutaneous coronary intervention (PCI) for severe calcified lesions is still challenging, and there are few studies of drug-eluting stent (DES) implantation for severe calcified lesions, especially regarding long-term results and hemodialysis patients. The study purpose was to clarify the factors, including DES strut thickness, that affect the long-term outcome of severe calcified lesion treated with rotational atherectomy. METHODS We analyzed 79 consecutive patients (138 stents) with DES implantation for severe calcified lesions that required rotational atherectomy before stent implantation. Rotational atherectomy was performed for the lesions that showed over 270° severe calcification by intravascular ultrasound (IVUS) or where IVUS could not cross the lesion. We compared coronary risk factors, acute coronary syndrome and hemodialysis, the patients' history of coronary bypass graft and myocardial infarction, medication, and procedure characteristics, including the thickness of the DES used (thin- or thick-strut [>100 μm] DES) between the patients with target vessel revascularization (TVR) versus those without TVR. RESULTS During the follow-up, TVR was performed in 30 patients (38.5%). A multivariate analysis revealed that age and thin-strut DES were independently related to TVR (P=.01 for both). A Kaplan-Meier curve showed a lower TVR rate in the thin-strut DES patients compared to the thick-strut DES patients. CONCLUSIONS For severe calcified lesions that needed rotational atherectomy, thin-strut DESs resulted in lower rates of TVR compared to thick-strut DESs.
منابع مشابه
The use of rotational atherectomy and drug-eluting stents in the treatment of heavily calcified coronary lesions.
INTRODUCTION The treatment of calcified coronary artery lesions is a challenge for percutaneous angioplasty. Rotational atherectomy is an established technique for the effective modification of these lesions prior to conventional angioplasty and stent implantation. Drug-eluting stents (DES) have shown encouraging results in complex lesions and high-risk patients. METHODS This retrospective st...
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Percutaneous coronary interventions (PCIs) are standard therapy for the treatment of atherosclerotic lesions of the coronary arteries. Since the introduction of rotational atherectomy (RA) in 1989, it has become established as a necessary adjunct to PCI in a small proportion of cases, notably calcified lesions. However, its use is hampered by the recurrent phenomenon of restenosis. The introduc...
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ورودعنوان ژورنال:
- The Journal of invasive cardiology
دوره 26 2 شماره
صفحات -
تاریخ انتشار 2014