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Rotational atherectomy of undilatable coronary stents: stentablation, a clinical perspective and recommendation

2016; European Association of Percutaneous Cardiovascular Interventions; Volume: 12; Issue: 5 Linguagem: Inglês

10.4244/eijv12i5a103

1969-6213

István Édes, Zoltán Ruzsa, György Szabó, Árpád Lux, László Gellér, Levente Molnár, Fanni Nowotta, Ágota Hajas, Bálint Szilveszter, Dávid Becker, Béla Merkely,

Integrated Circuits and Semiconductor Failure Analysis

Our aim was to examine procedural viability and midterm outcomes following the use of rotational atherectomy (RA) on malapposed, crippled, otherwise non-salvageable metallic stents (i.e., stentablation [SA]), and convey important procedural pointers for practitioners encountering such situations.Data on twelve SA subjects were analysed. The primary endpoint was procedural success: effective ablation of the malapposed stent and successful implantation of a new device. Major adverse cardiac events (MACE) and all-cause death at six months following the index procedure were examined as a secondary endpoint. All twelve patients underwent successful SA and novel stent implantation, with sufficient salvage of coronary anatomy (residual stenosis <30%). At six-month follow-up, however, MACE amounted to 50% and all-cause mortality to 25% in the inspected subjects.We found that, although feasible as an acute salvage option, SA distinctively increases post-procedural midterm MACE and mortality rates. This places emphasis on the importance of avoiding eventual SA situations, underlining the importance of ample lesion preparation prior to stent implantation.