Rotational Atherectomy Complicated by Coronary Perforation Is Associated With Poor Outcomes: Analysis of 10,980 Cases From the British Cardiovascular Intervention Society Database.
| Title: | Rotational Atherectomy Complicated by Coronary Perforation Is Associated With Poor Outcomes: Analysis of 10,980 Cases From the British Cardiovascular Intervention Society Database. |
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| Authors: | Protty MB; Department of Cardiology, University Hospital of Wales, Cardiff, UK; Systems Immunity University Research Institute, Cardiff University, Cardiff, UK.; Hussain HI; Department of Cardiology, University Hospital of Wales, Cardiff, UK.; Gallagher S; Department of Cardiology, University Hospital of Wales, Cardiff, UK.; Al-Raisi S; Department of Cardiology, University Hospital of Wales, Cardiff, UK.; Aldalati O; Department of Cardiology, University Hospital of Wales, Cardiff, UK.; Farooq V; Department of Cardiology, University Hospital of Wales, Cardiff, UK.; Sharp ASP; Department of Cardiology, University Hospital of Wales, Cardiff, UK; University of Exeter, Exeter, Devon, UK.; Anderson R; Department of Cardiology, University Hospital of Wales, Cardiff, UK.; Kinnaird T; Department of Cardiology, University Hospital of Wales, Cardiff, UK; Keele Cardiovascular Research Group, Institute of Applied Clinical Sciences, University of Keele, Stoke-on-Trent, UK. Electronic address: tim.kinnaird2@wales.nhs.uk. |
| Source: | Cardiovascular revascularization medicine : including molecular interventions [Cardiovasc Revasc Med] 2021 Jul; Vol. 28, pp. 9-13. Date of Electronic Publication: 2020 Aug 02. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Elsevier Country of Publication: United States NLM ID: 101238551 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-0938 (Electronic) Linking ISSN: 18780938 NLM ISO Abbreviation: Cardiovasc Revasc Med Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: New York, NY : Elsevier, c2005- |
| MeSH Terms: | Atherectomy, Coronary*/adverse effects ; Coronary Artery Disease*/diagnostic imaging ; Coronary Artery Disease*/epidemiology ; Coronary Artery Disease*/surgery ; Heart Injuries*/diagnostic imaging ; Heart Injuries*/epidemiology ; Heart Injuries*/etiology ; Percutaneous Coronary Intervention*/adverse effects; Databases, Factual ; Female ; Hospital Mortality ; Humans ; Retrospective Studies ; Risk Factors ; Treatment Outcome |
| Abstract: | Background: Rotational atherectomy (RA) during PCI is linked to a higher likelihood coronary perforations (CP). However, the evidence base on incidence, predictors and outcomes of this complication in RA-PCI remains limited.; Methods: Using the British Cardiac Intervention Society database, data were analysed on all RA-PCI procedures in UK 2007-2014. Descriptive statistics and multivariate logistic regressions were used to examine baseline, procedural and outcome associations.; Results: During 10,980 RA-PCI procedures, 167 CPs were recorded (1.52%) with a stable annual incidence. Baseline and procedural covariates associated with higher rates of RA perforation were number of stents used, female gender, smoking, and left-main stenosis. CP was significantly associated with shock, DC cardioversion, heart block, transfusion, emergency surgery, periprocedural MI, in-hospital major bleed, acute kidney injury, dissection, side branch loss and in-hospital death. CP was also associated with higher rates of in-hospital MACCE (OR 12.22, 95% CI 7.67-19.47), 30-day mortality (OR 10.02, 95% CI 5.87-17.09) and 12-month mortality (OR 3.90, 95% CI 2.53-6.02).; Conclusions: CP is more frequent in RA-PCI than all-comer PCI and is associated with a significant burden of morbidity and mortality. There are a limited number of baseline and procedural co-variates associated with CP in RA-PCI, making it difficult to predict.; (Copyright © 2020 Elsevier Inc. All rights reserved.) |
| Competing Interests: | Declaration of competing interest There are no conflicts of interest for any authors relevant to this work. |
| Contributed Indexing: | Keywords: Complications; Outcomes; Percutaneous coronary intervention; Perforation; Rotablation; Rotational atherectomy |
| Entry Date(s): | Date Created: 20200905 Date Completed: 20211022 Latest Revision: 20211022 |
| Update Code: | 20260130 |
| DOI: | 10.1016/j.carrev.2020.07.040 |
| PMID: | 32888836 |
| Database: | MEDLINE |
Journal Article