Long-term results of transradial rotational atherectomy for heavily calcified coronary artery lesions

Objective: Percutaneous coronary intervention (PCI) for the heavily calcified coronary lesions remains a challenge, and the periprocedural complication rates of the transfemoral approach are high. This study was conducted to investigate the feasibility and long-term results of the transradial approach for rotational atherectomy (RA) prior to stent implantation via the transradial approach in patients with heavily calcified coronary artery lesions. Methods: RA followed by stent implantation via the transradial approach was performed in 47 patients with severely calcified coronary artery lesions in this retrospectively case-control study. The success rate of the procedure and the 3-year follow-up (36±7.5 months) results were analyzed. Results: RA with subsequent stent implantation or balloon angioplasty procedures were successfully performed in all cases. 6F guiding catheters were used in 45 cases, and 7F catheters were used in 2 patients. Rotablation was performed with a 1.25-mm burr in 29 cases, a 1.25-mm burr followed by a 1.5-mm burr in 17 patients, and a 1.75-mm burr in 1 patient. Percutaneous transluminal coronary angioplasty after RA was performed, followed by stent implantation in all 47 patients. Restenosis was found in 7 cases (7/38) at 13 months (13±3.6) and in 13 cases (13/28) at 36 months (36±7.5) after the procedure; 3 patients died during the 3-year follow-up. The post-procedure cumulative 3-year event-free survival rate was 78%. Conclusion: RA prior to stent implantation via the transradial approach is feasible and safe, the success rate is high, and long-term outcome is satisfactory in patients with heavily calcified lesions of the coronary artery.