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BMC Cardiovascular Disorders

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Open Access 01-12-2016 | Research article

Intensive plaque modification with rotational atherectomy and cutting balloon before drug-eluting stent implantation for patients with severely calcified coronary lesions: a pilot clinical study

Authors: Qiyong Li, Yong He, Li Chen, Mao Chen

Published in: BMC Cardiovascular Disorders | Issue 1/2016

Abstract

Background

This study investigated whether, for patients with severely calcified coronary lesions, use of a cutting balloon (CB) during rotational atherectomy (RA) before placing a drug-eluting stent will improve periprocedural outcomes, compared to RA with a conventional plain balloon.

Methods

In a randomized controlled trial, patients with severely calcified lesions of calcium arc ≥180° were apportioned to receive intensive plaque modification with RA and CB (RA + CB; n = 35) or RA with conventional plain balloon (RA; n = 36). Intravascular ultrasound was applied for quantitative or qualitative analyses of percutaneous coronary intervention outcomes. The primary outcome was acute lumen gain after drug-eluting stent.

Results

The RA + CB and RA groups were similar in baseline mean arcs of superficial calcium, and minimum lumen cross-sectional areas (CSAs). The mean minimum stent CSA after percutaneous coronary intervention (PCI) of the RA + CB group (5.9 ± 1.7 mm²) was significantly larger than that of the RA group (5.0 ± 1.4 mm²; P = 0.021). Patients in the RA + CB group achieved significantly larger acute CSA gain after PCI (4.5 ± 1.5 mm²) relative to the RA group (3.8 ± 1.5 mm²; P = 0.035). The groups were similar in rates of periprocedural complications, but at the 1-year follow-up the RA + CB had a lower rate of revascularization for restenosis of the target vessel and MACE (5.7 %) than did the RA group (22.2 %, P = 0.046).

Conclusion

Aggressive plaque preparation with RA and CB seems to be safe and effective for patients with severely calcified coronary lesions.

Trial registration

Current Controlled Trials ChiCTR-INR-16008274. Retrospectively registered 12 April 2016.

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Title: Intensive plaque modification with rotational atherectomy and cutting balloon before drug-eluting stent implantation for patients with severely calcified coronary lesions: a pilot clinical study
Authors: Qiyong Li
Yong He
Li Chen
Mao Chen
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: BMC Cardiovascular Disorders / Issue 1/2016
Electronic ISSN: 1471-2261
DOI: https://doi.org/10.1186/s12872-016-0273-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Intensive plaque modification with rotational atherectomy and cutting balloon before drug-eluting stent implantation for patients with severely calcified coronary lesions: a pilot clinical study

Abstract

Background

Methods

Results

Conclusion

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Trial registration

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