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The incidence of slow flow after rotational atherectomy of calcified coronary arteries: A randomized study of low speed versus high speed
Author(s) -
Sakakura Kenichi,
Funayama Hiroshi,
Taniguchi Yousuke,
Tsurumaki Yoshimasa,
Yamamoto Kei,
Matsumoto Mitsunari,
Wada Hiroshi,
Momomura Shinichi,
Fujita Hideo
Publication year - 2017
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.26698
Subject(s) - timi , medicine , myocardial infarction , cardiology , thrombolysis , randomized controlled trial , incidence (geometry) , geometry , mathematics
Objectives The purpose of this randomized trial was to compare the incidence of slow flow between low‐speed and high‐speed rotational atherectomy (RA) of calcified coronary lesions. Background Preclinical studies suggest that slow flow is less frequently observed with low‐speed than high‐speed RA because of less platelet aggregation with low‐speed RA. Methods This was a prospective, randomized, single center study. A total of 100 patients with calcified coronary lesions were enrolled and randomly assigned in a 1:1 ratio to low‐speed (140,000 rpm) or high‐speed (190,000 rpm) RA. The primary endpoint was the occurrence of slow flow following RA. Slow flow was defined as slow or absent distal runoff (Thrombolysis in Myocardial Infarction [TIMI] flow grade ≤ 2). Results The incidence of slow flow in the low‐speed group (24%) was the same as that in the high‐speed group (24%) ( P = 1.00; odds ratio, 1.00; 95% confidence interval, 0.40–2.50). The frequencies of TIMI 3, TIMI 2, TIMI 1, and TIMI 0 flow grades were similar between the low‐speed (TIMI 3, 76%; TIMI 2, 14%; TIMI 1, 8%; TIMI 0, 2%) and high‐speed (TIMI 3, 76%; TIMI 2, 14%; TIMI 1, 10%; TIMI 0, 0%) groups ( P = 0.77 for trend). The incidence of periprocedural myocardial infarction was the same between the low‐speed (6%) and high‐speed (6%) groups ( P = 1.00). Conclusions This randomized trial did not show a reduction in the incidence of slow flow following low‐speed RA as compared with high‐speed RA (UMIN ID: UMIN000015702). © 2016 Wiley Periodicals, Inc.