Clinical impact of direct rotational atherectomy in patients with complex coronary artery lesions
Owing to limited data on the optimal timing of rotational atherectomy (RA), we sought to evaluate the clinical impact of the early application of the RA strategy. Consecutive patients with severe coronary artery calcification were enrolled, who underwent percutaneous coronary intervention (PCI) using RA between January 2010 and October 2019 at 9 tertiary centers. Direct RA was defined as the early application of RA before the balloon was expanded to a size more than or equal to 2.0 mm. The primary endpoint was the composite outcome of technical failure or severe coronary dissection (type D, E, or F) during entire procedure. Of 581 lesions, 360 (62.0%) lesions underwent direct RA. The technical success rate was higher in the direct RA group than in the indirect RA group (97.5% vs. 93.7%, p = 0.021). The primary endpoint was more frequently observed in the indirect RA group than in the direct RA group (24.4% vs. 11.9%, p < 0.001). Multivariate logistic regression analysis revealed that the risk of the primary endpoint was higher in the indirect RA group than in the direct RA group (odds ratio 2.512, 95% CI 1.547-4.078, p < 0.001). Early application of RA may reduce the incidences of in-hospital adverse events and procedure-related complications.
Authors
- Kyusup Lee (ORCID: https://orcid.org/0000-0003-0149-5503)
- Jang Hoon Lee (ORCID: https://orcid.org/0000-0002-7101-0236)
- Kyeong Ho Yun (ORCID: https://orcid.org/0000-0003-4911-8854)
- Ik Jun Choi (ORCID: https://orcid.org/0000-0001-9996-2346)
- Ki‐Dong Yoo (ORCID: https://orcid.org/0000-0001-5425-1102)
- Sang Rok Lee (ORCID: https://orcid.org/0000-0002-5845-2232)
- Pil Hyung Lee (ORCID: https://orcid.org/0000-0001-7339-9188)
- Seung‐Whan Lee (ORCID: https://orcid.org/0000-0002-2662-5952)
- Woojin Kwon (ORCID: https://orcid.org/0000-0001-6806-5677)
- Ji‐hoon Jung
- Mahn‐Won Park (ORCID: https://orcid.org/0000-0001-5293-8461)
- Sung‐Ho Her (ORCID: https://orcid.org/0000-0002-1548-4154)
- Jae‐Hwan Lee (ORCID: https://orcid.org/0000-0002-6561-7760)
- Dae‐Won Kim (ORCID: https://orcid.org/0000-0002-2219-1835)
- Hyun‐Jong Lee (ORCID: https://orcid.org/0000-0003-1260-0778)
- Yong Hoon Yoon
Institutions
- Ulsan College (KR)
- Chungnam National University (KR)
- Kyungpook National University Hospital (KR)
- Asan Medical Center (KR)
- University of Ulsan (KR)
- The Catholic University of Korea St. Vincent's Hospital (KR)
- Korea Institute of Toxicology (KR)
- Konyang University Hospital (KR)
- The Catholic University of Korea Daejeon St. Mary's Hospital (KR)
- Sejong General Hospital (KR)
- Jeonbuk National University Hospital (KR)
- Wonkwang University (KR)
- Catholic University of Korea (KR)
Publication Details
- Journal
- Scientific Reports
- Published
- 2025-02-03
- DOI
- https://doi.org/10.1038/s41598-025-88695-w
- Citations
- 1
- Primary Topic
- Coronary Interventions and Diagnostics
- Type
- article
- Field-Weighted Citation Impact
- 2.01