Rational use of rotational atherectomy in calcified lesions in the drug-eluting stent era: Review of the evidence and current practice. [Review]

MedStar author(s):
Citation: Cardiovascular Revascularization Medicine. 16(2):78-83, 2015 Mar.PMID: 25870151Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal Article | ReviewSubject headings: *Angioplasty, Balloon, Coronary/mt [Methods] | *Atherectomy, Coronary/mt [Methods] | *Coronary Artery Disease/th [Therapy] | *Drug-Eluting Stents | *Vascular Calcification/th [Therapy] | Angioplasty, Balloon, Coronary/ae [Adverse Effects] | Atherectomy, Coronary/ae [Adverse Effects] | Coronary Angiography/mt [Methods] | Coronary Artery Disease/ra [Radiography] | Coronary Restenosis/ep [Epidemiology] | Coronary Restenosis/ra [Radiography] | Coronary Restenosis/th [Therapy] | Evidence-Based Medicine | Female | Follow-Up Studies | Humans | Male | Randomized Controlled Trials as Topic | Risk Assessment | Survival Rate | Time Factors | Treatment Outcome | Vascular Calcification/mo [Mortality] | Vascular Calcification/ra [Radiography]Year: 2015Local holdings: Available in print through MWHC library: 2002 - presentISSN:
  • 1878-0938
Name of journal: Cardiovascular revascularization medicine : including molecular interventionsAbstract: Percutaneous coronary interventions of calcified coronary lesions are associated with worse clinical outcomes compared with noncalcified lesions and are still considered a technical challenge for interventional cardiologists. Rotational atherectomy (RA) can effectively optimize lesion preparation through plaque modification of heavily calcified coronary lesions. However, in conventional balloon angioplasty and bare metal stent eras, the use of RA was not associated with a significant improvement in restenosis and target lesion revascularization in patients with calcified lesions. Drug-eluting stents (DES) dramatically reduced the rates of restenosis and major adverse cardiac events. In the DES era, the need for RA is therefore questionable. Recently, some studies have reported clinical outcomes of patients with calcified lesions treated with DES and RA. In this article, we aim to critically review results from these randomized and observational clinical studies assessing the use of RA in the DES era.Copyright � 2015. Published by Elsevier Inc.All authors: Lhermusier T, Minha S, Tian W, Waksman RFiscal year: FY2015Digital Object Identifier: Date added to catalog: 2016-01-19
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Journal Article MedStar Authors Catalog Article 25870151 Available 25870151

Available in print through MWHC library: 2002 - present

Percutaneous coronary interventions of calcified coronary lesions are associated with worse clinical outcomes compared with noncalcified lesions and are still considered a technical challenge for interventional cardiologists. Rotational atherectomy (RA) can effectively optimize lesion preparation through plaque modification of heavily calcified coronary lesions. However, in conventional balloon angioplasty and bare metal stent eras, the use of RA was not associated with a significant improvement in restenosis and target lesion revascularization in patients with calcified lesions. Drug-eluting stents (DES) dramatically reduced the rates of restenosis and major adverse cardiac events. In the DES era, the need for RA is therefore questionable. Recently, some studies have reported clinical outcomes of patients with calcified lesions treated with DES and RA. In this article, we aim to critically review results from these randomized and observational clinical studies assessing the use of RA in the DES era.Copyright � 2015. Published by Elsevier Inc.

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