{
  "abstract": "Introduction Complex coronary lesions with significant calcification present major challenges for percutaneous coronary intervention (PCI), impeding stent delivery, expansion, and overall procedural success. Rotational atherectomy (RA) has been widely used over the past decade to modify calcified plaques, improving PCI outcomes. This study evaluates the efficacy and safety of RA in complex calcified lesions over a 5-year period in a high-volume centre.Methods We conducted a retrospective analysis of patients who underwent RA at our center, using NICOR data(2018 - 2022). Clinical characteristics, EuroSCORE surgical risk, procedural outcomes, and complications were examined.Results RA was used in 125(3.4%) of 3,680 PCIs between 2018 to 2022. The characteristics of these patients are detailed below.Abstract 2-031 Table 1Baseline characteristics of patients of patients undergone PCI with RA Characteristic Value Percentage Male9172.8%Mean Age73.7 +/- 9.3-Mean BMI27.8 +/- 6.1-Diabetes7257.6%Renal impairment Creatinine > 200 µmol/l118.8%Current or Ex-smoker7560.0%Left ventricular ejection fraction (LVEF) < 50%3326.4%Of 125 patients, 70 had acute coronary syndrome (7 primary PCI (5.6%) , 63 non-STEMI/unstable angina(50.4%)) and 55 stable angina (44%). The procedure was performed as elective for 51 cases (41%), urgent for 64 cases (51%) and emergency for 10(8%) (figure 1).Abstract 2-031 Figure 1Procedural urgency of patients undergoing rotational atherectomyAmong them, 1 had recent thrombolysis, 61 had previous myocardial infarction (MI), 18 had coronary artery bypass grafting (CABG), and 42 had prior PCI (figure 2).Abstract 2-031 Figure 2Cardiac history of patients undergoing rotational atherectomyThe EuroSCORE distribution showed 8 patients (6.4%) as low risk (0–2), 41 patients (32.8%) as moderate risk (3–5) and 57 patients (45.6%) as high-risk score (6 or more). 19 patients (15.2%) had incomplete data.Abstract 2-031 Table 2Targeted vessels for rotational atherectomy and in-hospital complications Category Description Number Percentage Targeted vesselLMS1512.0% LAD7963.2% LCX2016.0% RCA3628.8%MACEDeath54.0% Q-wave myocardial infarction10.8% Stroke10.8% Emergency CABG00.0%other complicationArterial complication10.8%Burr sizes ranged from 1.25 mm to 2 mm, with burr times between 17 and 360 seconds. A single burr was used in 69.6% (n=87). One procedure was abandoned after an initial attempt, while the remainder were successfully completed with good angiographic results. The mortality rate for the standard PCI in our centre during the same period was 3.92%, and statistical analysis confirmed no significant difference compared to RA (p = 0.967). There was no mortality among the 51 patients who underwent the elective procedure.Conclusion Rotational atherectomy is a safe and effective strategy for the preparation of heavily calcified coronary lesions, facilitating successful PCI in both acute and elective settings. In our cohort, the overall in-hospital mortality rate was not statistically different to standard PCI. The incidence of other major adverse cardiac events (MACE) was low, with one Q-wave myocardial infarction (0.8%) and one stroke (0.8%).",
  "authors": [
    {
      "affiliations": [
        "Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust"
      ],
      "name": "Banya Aung Myint"
    },
    {
      "affiliations": [
        "Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust"
      ],
      "name": "Ayham Al-Shatanaw"
    },
    {
      "affiliations": [
        "Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust"
      ],
      "name": "Anwar Hussain"
    },
    {
      "affiliations": [
        "Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust"
      ],
      "name": "Farhan Shahid"
    },
    {
      "affiliations": [
        "Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust"
      ],
      "name": "Sohail Khan"
    },
    {
      "affiliations": [
        "Medical School, University of Birmingham"
      ],
      "name": "Raman Nagra"
    },
    {
      "affiliations": [
        "Medical School, University of Birmingham"
      ],
      "name": "Sanjanna Kamalakannan"
    }
  ],
  "title": "2-031 Evaluating in-hospital outcomes of PCI with rotational artherectomy: a five-year experience",
  "uid": "17956417-2a76-5d85-b378-7b8f7112f068"
}