The role of rotational atherectomy in contemporary chronic total occlusion percutaneous coronary intervention

2017 ◽  
Vol 89 (5) ◽  
pp. 829-831 ◽  
Author(s):  
Yader Sandoval ◽  
Emmanouil S. Brilakis
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Rotational Atherectomy ◽  
Total Occlusion ◽  
Percutaneous Coronary

scholarly journals Rotational Atherectomy-Assisted Crossing of a Complex Right Coronary Artery Lesion Using the Retrograde Approach

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Abdul-Subulr Yakubu ◽  
Xiaoqiang Zhang ◽  
Bin Zhang
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Rotational Atherectomy ◽  
Retrograde Approach ◽  
Total Occlusion ◽  
Interventional Cardiologist ◽  
Percutaneous Coronary

Chronic total occlusion lesions present a major challenge for the interventional cardiologist. In this case, we report the successful use of rotational atherectomy to facilitate retrograde percutaneous coronary intervention of a complex totally occluded right coronary artery after modification of the proximal cap of the lesion to enable placement of the RotaWire in the vessel architecture.

scholarly journals A risk predictive model for coronary perforation in patients undergoing percutaneous coronary intervention – APOLLO-XI score

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Jaspattananon ◽  
N Wongpraparut ◽  
C Chotinaiwattarakul ◽  
R Phankingthongkum ◽  
W Tungsubutra ◽  
...  
Keyword(s):  
Risk Factors ◽  
Percutaneous Coronary Intervention ◽  
Predictive Model ◽  
Chronic Total Occlusion ◽  
Cumulative Risk ◽  
Coronary Intervention ◽  
Rotational Atherectomy ◽  
Total Occlusion ◽  
Coronary Perforation ◽  
Percutaneous Coronary

Abstract Background Coronary perforation (CP) is a rare but potentially life-threatening complication of percutaneous coronary intervention (PCI). Although several variables are associated with the risk of coronary perforation, a cumulative risk predictive model has not been established yet. Purpose To assess an incidence, risk factors and to develop risk predictive model for coronary perforation following PCI. Methods A single center, retrospective study of patients who underwent PCI from March 2010 to December 2019. Multivariate regression analysis was performed to identify independent predictors of CP. A risk predictive model was constructed with incremental weights attributed to each component variable according to their beta coefficients. Results 10,671 PCI procedures were enrolled. The incidence of CP was 0.94%. Adverse in-hospital outcomes were significant higher in CP group, including death (odds ratio [OR]: 3.58), mechanical circulatory support; including IABP and ECMO (OR: 3.79) and urgent revascularization (OR: 7.35). Multivariable analysis identified seven independent risk factors for CP, which were age (OR: 1.02), insulin-treated diabetes (OR: 2.50), prior CABG (OR: 2.03), hydrophilic guidewire (OR: 1.62), rotational atherectomy (OR: 2.60), excimer laser coronary atherectomy (ELCA) (OR: 3.39) and chronic total occlusion PCI (OR: 4.21). Risk predictive model (APOLLO-XI score) was calculated from the total points of each variables as follows: age (1 point per 10-year increase), hydrophilic guidewire (2 points), prior CABG (3 points), insulin-treated diabetes or rotational atherectomy (4 points), ELCA (5 points) and chronic total occlusion PCI (6 points). Cumulative risk score more than 11 points had increased risk for coronary perforation more than 1%. The validation of the risk predictive model (C-statistic) was 0.75 (95% CI: 0.70–0.80). Conclusions Coronary perforation is a rare but lethal complication. Our study demonstrates the risk predictive model which could enhance cardiovascular team to precisely estimate risk of coronary perforation before complex PCI procedure. FUNDunding Acknowledgement Type of funding sources: None. Baseline charecteristics APOLLO-XI score

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