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Open Access 01-12-2024 | Review

Safety and feasibility of rotational atherectomy (RA) versus conventional stenting in patients with chronic total occlusion (CTO) lesions: a systematic review and meta-analysis

Authors: Ahmed Abdelaziz, Hanaa Elsayed, Aboalmagd Hamdaalah, Karim Atta, Ahmed Mechi, Hallas Kadhim, Aya Moustafa Aboutaleb, Ahmed Elaraby, Mohamed Hatem Ellabban, Fayed Mohamed Rzk, Mahmoud Eid, Hadeer Elsaeed AboElfarh, Rahma AbdElfattah Ibrahim, Emad Addin Zawaneh, Mahmoud Ezzat, Mohamed Abdelaziz, Abdelrahman H. Hafez, Shaimaa Fadel, Hazem S. Ghaith, Mustafa Suppah

Published in: BMC Cardiovascular Disorders | Issue 1/2024

Abstract

Background and aim

Interventional cardiologists face challenges in managing chronic total occlusion (CTO) lesions, with conflicting results when comparing rotational atherectomy (RA) to conventional PCI. This meta-analysis aims to provide a critical evaluation of the safety and feasibility of RA in CTO lesions.

Methods

PubMed, Scopus, Web of Science, Ovid, and Cochrane central library until April 2023 were searched for relevant studies. MACE was our primary outcomes, other outcomes were all cause of death, cardiac death, MI, and TVR. Also, we reported angiographic outcomes as technical success, procedural success, and procedural complications in a random effect model. The pooled data was analyzed using odds ratio (OR) with its 95% CI using STATA 17 MP.

Results

Seven studies comprising 5494 patients with a mean follow-up of 43.1 months were included in this meta-analysis. Our pooled analysis showed that RA was comparable to PCI to decrease the incidence of MACE (OR = 0.98, 95% CI [0.74 to 1.3], p = 0.9). Moreover, there was no significant difference between RA and conventional PCI in terms of other clinical or angiographic outcomes.

Conclusion

Our study showed that RA had comparable clinical and angiographic outcomes as conventional PCI in CTO lesions, which offer interventional cardiologists an expanded perspective when addressing calcified lesions.

PROSPERO registration

CRD42023417362.

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Title: Safety and feasibility of rotational atherectomy (RA) versus conventional stenting in patients with chronic total occlusion (CTO) lesions: a systematic review and meta-analysis
Authors: Ahmed Abdelaziz
Hanaa Elsayed
Aboalmagd Hamdaalah
Karim Atta
Ahmed Mechi
Hallas Kadhim
Aya Moustafa Aboutaleb
Ahmed Elaraby
Mohamed Hatem Ellabban
Fayed Mohamed Rzk
Mahmoud Eid
Hadeer Elsaeed AboElfarh
Rahma AbdElfattah Ibrahim
Emad Addin Zawaneh
Mahmoud Ezzat
Mohamed Abdelaziz
Abdelrahman H. Hafez
Shaimaa Fadel
Hazem S. Ghaith
Mustafa Suppah
Publication date: 01-12-2024
Publisher: BioMed Central
Published in: BMC Cardiovascular Disorders / Issue 1/2024
Electronic ISSN: 1471-2261
DOI: https://doi.org/10.1186/s12872-023-03673-2

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Safety and feasibility of rotational atherectomy (RA) versus conventional stenting in patients with chronic total occlusion (CTO) lesions: a systematic review and meta-analysis

Abstract

Background and aim

Methods

Results

Conclusion

PROSPERO registration

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Abstract

Background and aim

Methods

Results

Conclusion

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