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Procedural and 1‐year clinical outcomes of orbital atherectomy for treatment of coronary in‐stent restenosis: A single‐center, retrospective study
Author(s) -
Yasumura Keisuke,
Benhuri Benjamin,
Vengrenyuk Yuliya,
Petrov Artiom,
Barman Nitin,
Sweeny Joseph,
Kapur Vishal,
Suleman Javed,
Baber Usman,
Mehran Roxana,
Stone Gregg W.,
Kini Annapoorna S.,
Sharma Samin K.
Publication year - 2021
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.28983
Subject(s) - medicine , mace , restenosis , percutaneous coronary intervention , conventional pci , stent , myocardial infarction , debulking , angioplasty , surgery , retrospective cohort study , cardiology , ovarian cancer , cancer
Objectives We evaluated the procedural and 1‐year clinical outcomes of orbital atherectomy (OA) for treatment of coronary in‐stent restenosis (ISR). Background The optimal treatment for ISR remains uncertain. While rotational and laser atherectomy have been used as neointimal debulking techniques for ISR, there have been few reports on OA for ISR. Methods This is a retrospective observational study of consecutive patients who underwent percutaneous coronary intervention (PCI) for ISR with OA in Mount Sinai catheterization laboratory between November 2013 and January 2018. Procedural success was defined as angiographic success without in‐hospital major adverse cardiac events (MACE; the composite of all‐cause death, myocardial infarction [MI], or target vessel revascularization). Clinical outcomes were assessed at 1 month and 12 months postprocedure. Results A total of 87 patients were included in the study. All 87 patients were treated with OA, after which 49 (56.3%) patients also received new drug‐eluting stents. Angiographic success was achieved in 87 (100%) patients and procedural success was achieved in 79 (90.8%) patients. In‐hospital MACE occurred in 8 (9.2%) patients, all due to periprocedural non‐Q‐wave MI. Acute lumen gain was 1.19 ± 0.57 mm after OA plus balloon angioplasty and 1.75 ± 0.50 mm after stent placement. MACE within 1 year occurred in 17 (19.5%) patients. Conclusions OA for ISR was performed with favorable procedural and 1‐year clinical outcomes. Randomized trials are warranted to determine whether OA improves the poor prognosis of patients with ISR treated without debulking.