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Rotational Atherectomy

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Rotational atherectomy in the subadventitial space to allow safe and successful chronic total occlusion recanalization: Pushing the limit further Prevalence, Presentation and Treatment of 'Balloon Undilatable' Chronic Total Occlusions: Insights from a Multicenter US Registry A Meta-Analysis of Contemporary Lesion Modification Strategies During Percutaneous Coronary Intervention in 244,795 Patients From 22 Studies Rotational atherectomy and new-generation drug-eluting stent implantation Long-term outcomes of rotational atherectomy of underexpanded stents. A single center experience Short-term and long-term clinical outcomes of rotational atherectomy in resistant chronic total occlusion Rotational Atherectomy Followed by Drug-Coated Balloon Dilation for Left Main In-Stent Restenosis in the Setting of Acute Coronary Syndrome Complicated with Right Coronary Chronic Total Occlusion Optical frequency-domain imaging findings to predict good stent expansion after rotational atherectomy for severely calcified coronary lesions Radial Versus Femoral Access for Rotational Atherectomy: A UK Observational Study of 8622 Patients Transverse partial stent ablation with rotational atherectomy for suboptimal culotte technique in left main stem bifurcation
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Original Research2017 Dec;10(12).

JOURNAL:Circ Cardiovasc Interv. Article Link

Radial Versus Femoral Access for Rotational Atherectomy: A UK Observational Study of 8622 Patients

Watt J, Austin D, Mackay D et al. Keywords: access site; atherectomy; hemorrhage; radial artery

ABSTRACT


BACKGROUND - Rotational atherectomy (RA) is an important interventional tool for heavily calcified coronary lesions. We compared the early clinical outcomes in patients undergoing RA using radial or femoral access.


METHODS AND RESULTS - We identified all patients in England and Wales who underwent RA between January 1, 2005, and March 31, 2014. Eight thousand six hundred twenty-two RA cases (3069 radial and 5553 femoral) were included in the analysis. The study primary outcome was 30-day mortality. Propensity scores were calculated to determine the factors associated with treatment assignment to radial or femoral access. Multivariable logistic regression analysis, using the calculated propensity scores, was performed. Thirty-day mortality was 2.2% in the radial and 2.3% in the femoral group (P=0.76). Radial access was associated with equivalent 30-day mortality (adjusted odds ratio [OR], 1.06; 95% confidence interval [CI], 0.77-1.46; P=0.71), procedural success (OR, 1.04; 95% CI, 0.84-1.29; P=0.73), major adverse cardiac and cerebrovascular events (OR, 1.05; 95% CI, 0.80-1.38; P=0.72), and net adverse clinical events (OR, 0.90; 95% CI, 0.71-1.15; P=0.41), but lower rates of in-hospital major bleeding (OR, 0.62; 95% CI, 0.40-0.98; P=0.04) and major access site complications (OR, 0.05; 95% CI, 0.01-0.38; P=0.004), compared with femoral access.


CONCLUSIONS - In this large real-world study of patients undergoing RA, radial access was associated with equivalent 30-day mortality and procedural success, but reduced major bleeding and access site complications, compared with femoral access.


© 2017 American Heart Association, Inc.