The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Coronary interventions

Clinical outcomes of PCI with rotational atherectomy: the European multicentre Euro4C registry

EuroIntervention 2020;16:e305-e312. DOI: 10.4244/EIJ-D-19-01129

1. Department of Cardiology, Rangueil Toulouse University Hospital, Toulouse, France; 2. Division of Cardiology, Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy; 3. Department of Heart Diseases, Wroclaw Medical University, Wrocław, Poland; Military Hospital, Wroclaw, Poland; 4. Military Hospital, Wroclaw, Poland; 5. Department of Invasive Cardiology, State Teaching Hospital, Medical University of Bialystok, Bialystok, Poland; 6. Augusta Krankenhaus, Düsseldorf, Germany; 7. Nouvelles cliniques Nantaises, Nantes, France; 8. Department of Cardiology, Centre Hospitalier Universitaire de Nîmes, Université de Montpellier, Nimes, France; 9. Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland; 10. Department of Cardiology, Hospital Universitario Central de la Defensa Gómez Ulla, Madrid, Spain; 11. Department of Cardiology and Angiology II, University Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany; 12. Division of Cardiology, University of Verona, Verona, Italy

Aims: Despite the use of rotational atherectomy (RA) in interventional cardiology for over three decades, data regarding factors affecting the clinical outcomes of the RA procedure remain scarce. The aim of the present study was to describe the contemporary use and outcomes of RA in Europe.

Methods and results: We conducted, for the first time, a prospective international registry in 8 European countries and 19 centres and included patients treated by percutaneous coronary intervention with RA. Between October 2016 and July 2018, 966 patients with complete data were recruited. Mean age was 74.5 years, 72.4% were male and 43.4% had diabetes. Initial presentation was an acute coronary syndrome (ACS) for 25.1% of the patients. Clinical success was observed in 91.9% of the procedures. The rate of in-hospital major adverse cardiac events (MACE) – defined as cardiovascular death, myocardial infarction, target lesion revascularisation, stroke and coronary artery bypass grafting – was 4.7%. At one year, the rate of MACE was 13.2%. Factors independently associated with the occurrence of MACE at one year were female gender, renal failure, ACS at admission, depressed left ventricular ejection fraction (LVEF) and presence of a significant left main coronary artery (LMCA) lesion.

Conclusions: Despite the high level of complexity of the studied population, RA turned out to be an effective procedure with a low rate of in-hospital complications and demonstrated good immediate and midterm results.

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