TORNA ALL’ELENCO

Clinical outcome of rotational atherectomy in complex calcified coronary lesions: Data from the large multicenter Italian registry ROTATE in European Heart Journal

2014
ASL Città di Torino
ASL Torino 4
AO Ordine Mauriziano

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (17)Vedi tutti...

Boccuzzi G
RSA Villa Serena, Bologna (BO), Italy
Boasi VB
RSA Villa Serena, Bologna (BO), Italy
Latib A
RSA Villa Serena, Bologna (BO), Italy

et alii...

Abstract

Purpose: The ROTATE (ROTational AThEerectomy) multicenter Italian registry was developed to assess the short and long term outcome after RA in a large real world population. Methods: From April 2002 to December 2013 a total of 801 consecutive patients, treated with rotational atherectomy in 8 different hospitals, were collected in the Italian multi-center ROTATE registry. Results: Baseline patient characteristics were: mean age 70.6±9.8 years, 79.3% male, 37.3% diabetes mellitus and 39.9% previous PCI. More than a third of patients (35.2%) were treated with RA during the hospitalization for an acute coronary syndrome. In 29.9% of cases the procedure was performed by trans-radial approach. The most frequently treated coronary artery was the left anterior descending (48.6%) followed by the right coronary (23.9%); protected and unprotected left main stem lesions were respectively faced in 1.8% and 3.3%. Chronic total occlusions were 8.9% of total and 19.8% of procedures were IVUS-guided. Use of intra-aortic balloon pump was needed in 4.9%. The most used burr sizes were the 1.5 mm (43%) and the 1.25 mm (37%). Median total stent length per patient was 41.6±24.1 mm. The majority of patients were treated with first and second generation DES, only 9.9% did not received a DES. Serious procedural complications, perforation and no/slow flow, occurred respectively in 0.6% and 1.3% of cases. In hospital death occurred in 0.8%, myocardiaI infarction (Q and nonQ wave infarction) in 5.9% and stroke in 0.4%. The incidence of in-hospital major cardiac adverse events defined as death, MI and target vessel revascularization was 7.2%, with no differences between gender and clinical presentation, whereas it resulted lower in the trans-radial approach patients (3% in trans-radial vs 9% in trans-femoral, p=0.002). In a multivariate regression model analysis (covariates: age, sex, weight, diabetes mellitus, ejection fraction, AHA/ACC lesion type, vascular approach, IVUS guidance),

DOI : 10.1093/eurheartj/ehu323

Keywords

heart ejection fraction; coronary artery; gender; occlusion; model; weight; overall survival; intraaortic balloon pump; Kaplan Meier method; stent; hospitalization; perforation; population; procedures; cerebrovascular accident; revascularization; infarction; diabetes mellitus; death; hospital; patient; human; cardiology; society; register; rotational atherectomy; acute coronary syndrome; survival; male;