Impact of Lesion Preparation Technique on Side Branch Compromise in Calcified Coronary Bifurcations: A Subgroup Analysis of the PREPARE-CALC Trial.
Aged
Angioplasty, Balloon, Coronary
/ adverse effects
Atherectomy, Coronary
/ adverse effects
Coronary Angiography
/ methods
Coronary Artery Disease
/ pathology
Coronary Vessels
/ diagnostic imaging
Female
Humans
Male
Outcome and Process Assessment, Health Care
Postoperative Complications
/ etiology
Risk Adjustment
/ methods
Vascular Calcification
/ diagnosis
Journal
Journal of interventional cardiology
ISSN: 1540-8183
Titre abrégé: J Interv Cardiol
Pays: United States
ID NLM: 8907826
Informations de publication
Date de publication:
2020
2020
Historique:
received:
16
05
2020
revised:
15
08
2020
accepted:
24
10
2020
entrez:
23
11
2020
pubmed:
24
11
2020
medline:
24
4
2021
Statut:
epublish
Résumé
To analyze the impact of different techniques of lesion preparation of severely calcified coronary bifurcation lesions. The impact of different techniques of lesion preparation of severely calcified coronary bifurcation lesions is poorly investigated. We performed an as-treated analysis on 47 calcified bifurcation lesions treated with scoring/cutting balloons (SCB) and 68 lesions treated with rotational atherectomy (RA) in the PREPARE-CALC trial. Compromised side branch (SB) as assessed in the final angiogram was the primary outcome measure and was defined as any significant stenosis, dissection, or thrombolysis in myocardial infarction flow <3. True bifurcation lesions were present in 49% vs. 43% of cases in the SCB and RA groups, respectively. After stent implantation, SB balloon dilatation was necessary in around one-third of cases (36% vs. 38%; In the PREPARE-CALC trial, side branch compromise was more frequently observed after lesion preparation with SCB as compared with RA. Consequently, in calcified bifurcation lesions, an upfront debulking with an RA-based strategy might optimize the result in the side branch.
Sections du résumé
OBJECTIVES
OBJECTIVE
To analyze the impact of different techniques of lesion preparation of severely calcified coronary bifurcation lesions.
BACKGROUND
BACKGROUND
The impact of different techniques of lesion preparation of severely calcified coronary bifurcation lesions is poorly investigated.
METHODS
METHODS
We performed an as-treated analysis on 47 calcified bifurcation lesions treated with scoring/cutting balloons (SCB) and 68 lesions treated with rotational atherectomy (RA) in the PREPARE-CALC trial. Compromised side branch (SB) as assessed in the final angiogram was the primary outcome measure and was defined as any significant stenosis, dissection, or thrombolysis in myocardial infarction flow <3.
RESULTS
RESULTS
True bifurcation lesions were present in 49% vs. 43% of cases in the SCB and RA groups, respectively. After stent implantation, SB balloon dilatation was necessary in around one-third of cases (36% vs. 38%;
CONCLUSIONS
CONCLUSIONS
In the PREPARE-CALC trial, side branch compromise was more frequently observed after lesion preparation with SCB as compared with RA. Consequently, in calcified bifurcation lesions, an upfront debulking with an RA-based strategy might optimize the result in the side branch.
Identifiants
pubmed: 33223974
doi: 10.1155/2020/9740938
pmc: PMC7673940
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
9740938Informations de copyright
Copyright © 2020 Abdelhakim Allali et al.
Déclaration de conflit d'intérêts
Dr. Allali is a proctor for Boston Scientific. Dr. Abdel-Wahab is a consultant and proctor for Boston Scientific and Medtronic. Dr. Hemetsberger is an honorary speaker for Boston Scientific. Dr. Richardt has received institutional research grants from St. Jude Medical, Biotronik and Medtronic. The other authors have no conflicts of interest to declare.
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