ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Coronary Artery Disease
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1599091
This article is part of the Research TopicAdvancements in Coronary Calcium Modification: Safety and Efficacy of Emerging TechniquesView all articles
Planned versus Rescue Rotational Atherectomy in Severe Coronary Stenosis: Procedural Complications and One-Year Clinical Outcomes
Provisionally accepted
- Department of Cardiology, Wuhan Fourth Hospital, Wuhan, Hebei Province, China
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Objective: Present study compared the procedural and one-year clinical outcome of planned (pRA) or rescue RA (rRA) for patients undergoing percutaneous coronary intervention with severe coronary stenosis and calcification. Methods: A total of 111 consecutive patients who underwent RA at the Fourth Hospital of Wuhan from July 2021 to June 2023 were enrolled. The general clinical data, coronary artery lesion characteristics, procedural characteristics, complication rate and major cerebral and cardiovascular event (MACCE, cardiac death, acute myocardial infarction (AMI), target vessel revascularization or acute ischemic stroke) rate at one year after procedure were compared between the two groups. Results: According to the timing of initiation of RA, patients were stratified into pRA group (n=84) or rRA group (n=27). Baseline clinical characteristics were similar between the two groups. The number of stents implanted was similar in the two groups. The rRA group required more pre - dilation balloons (1.7 ± 0.7 vs. 3.4 ± 0.5, P < 0.001), exhibited a higher rate of coronary artery dissection (29.6% vs. 7.1%, P = 0.02) and consumed a larger volume of contrast (189.8 ± 59 ml vs. 139.9 ± 46 ml, P < 0.001). Additionally, the incidence of contrast - induced nephropathy was significantly greater in the rRA group (29.6% vs. 9.5%, P = 0.01), and the procedure duration was markedly longer in this group compared to the pRA group (91.5 ± 24.3 min vs. 77.9 ± 25.2 min, P < 0.001). Multivariable logistic regression identified rRA as an independent predictor of periprocedural complications (adjusted OR = 2.83; 95% CI:1.01–7.99; P = 0.048). However, 1-year MACCE rates showed no intergroup difference (pRA 3.7% vs. rRA 4.8%; P = 1.00). No significant difference in the secondary endpoints of non-cardiac death, angina pectoris, heart failure, and cardiovascular rehospitalization were observed between the two groups. Conclusion: rRA is related with higher procedural complication rates, procedure time, and contrast agent dose compared with pRA, but has similar low MACCE rate as pRA at one year after procedure
Keywords: Planned rotational atherectomy, Rescue rotational atherectomy, Outcome, severe calcified lesions, MACCE: Major adverse cardiac and cerebrovascular events
Received: 24 Mar 2025; Accepted: 04 Jun 2025.
Copyright: © 2025 Xiaogang, Lei, Yufeng, Gu and Liqun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hu Liqun, Department of Cardiology, Wuhan Fourth Hospital, Wuhan, Hebei Province, China
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