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Reviews in Cardiovascular Medicine  2020, Vol. 21 Issue (2): 309-314     DOI: 10.31083/j.rcm.2020.02.36
Original Research Previous articles |
Short-term and long-term outcomes of bailout versus planned coronary rotational atherectomy
Zhanru Qi1, , Hongyan Zheng1, , Zhonghai Wei1, Qing Dai1, Jun Xie1, Lian Wang1, Jingmei Zhang1, 2, *(), Jie Song1, *()
1Department of Cardiology, Nanjing Drum Tower Hospital, The Affiliated Hospital to Nanjing University Medical School, Nanjing, Jiangsu, 210008, P. R. China
2Department of Cardiology, Yizheng Hospital, Nanjing Drum Tower Hospital Group, Yizheng, 211900, P. R. China
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The goal of this study was to compare in-hospital and long-term events between bailout rotational atherectomy (RA) and planned RA. In this retrospective study, All patients who underwent percutaneous coronary intervention (PCI) using RA at Nanjing Drum Tower Hospital from November 2011 to December 2018 were enrolled in this study. Planned RA was defined as RA performed immediately before balloon pre-dilation, while bailout RA was defined as RA after failure to expand the balloon or perform any other procedure. In-hospital and long-term major adverse cardiac events (MACE, defined as cardiac mortality, myocardial infarction (MI), target vessel revascularization (TVR) and stroke) were compared between the two groups. After statistical analysis, a total of 211 patients underwent PCI with RA during the study period: 153 in the planned RA group, and 58 in the bailout group. The incidence of coronary dissection was significantly higher in the bailout RA group than in the planned RA group (22.4% vs. 6.5%, P = 0.001). However, no significant difference in in-hospital MACE was found between the two groups (12.1% vs. 13.7%, P = 0.752). There was no difference in all-cause mortality (9.1% vs. 12.5%, P = 0.504) or long-term MACE (13.8% vs. 17.1%, P = 0.560) between the groups. Bailout RA was associated with a significantly longer procedural time (139.86 ± 56.24 min vs. 105.56 ± 36.71 min, P < 0.001) than planned RA. Therefore, compared with bailout RA, planned RA is associated with shorter procedural time and reduced incidence of coronary dissection, with no difference in MACE or mortality.
Key words:  Rotational atherectomy      coronary artery disease      calcification     
Submitted:  18 March 2020      Revised:  22 June 2020      Accepted:  23 June 2020      Published:  30 June 2020     
2016-WSN-157/Six talent peaks project in Jiangsu Province
YKK17085/Municipal Medical Science Technology Development Foundation of Nanjing
*Corresponding Author(s): (Jie Song) and (Jingmei Zhang)   
About author:  These authors contributed equally.

Cite this article: 

Zhanru Qi, Hongyan Zheng, Zhonghai Wei, Qing Dai, Jun Xie, Lian Wang, Jingmei Zhang, Jie Song. Short-term and long-term outcomes of bailout versus planned coronary rotational atherectomy. Reviews in Cardiovascular Medicine, 2020, 21(2): 309-314.

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