Author + information
- Antoinette Neylon1,
- Leticia Fernandez-Lopez2,
- Andrew Roy3,
- Bernard Chevalier4,
- Thierry Lefevre5 and
- Philippe Garot6
Frequently the treatment of complex calcified lesions requiring rotational atherectomy mandates a femoral approach. We aim to assess access routes and outcomes in 3 centres with a default strategy for radial interventions.
From a prospective database of all coronary angioplasties between 2009 and 2015 we identified all who had rotablator-assisted procedures. Data pertaining to baseline demographics, details of interventional procedure and in-hospital outcomes were collected.
Rotablator guided procedures represented 2.02% of angioplasties performed (399/19,730). The mean age was 72± 9 years and 317 (79%) were male. Previous bypass grafting had been performed in 12.8% (51) and the procedure was performed in an elective setting in 93% (356). Interventions were performed via radial route 87% (347), femoral 11.5% (46) and brachial in 1.6% (6). A 6Fr system was used in 91.5% (365) and temporary pacing wire was inserted in 1 case. The majority of cases utilized a 1.25 (36.4%) or 1.5mm (47.1%) burr followed by a 1.75 (14%) and a 2.0 in (2.5%). When a 2.0mm burr was required 7Fr access was via radial/brachial route in 70% (7) of cases. Crossover to femoral access was required to realise the procedure in 13 cases (3.3%). Procedural success rates were not significantly different between groups (96.5% for radial and 97.8% femoral; p 0.93). The burr crossed the lesion in 98% of cases. In-hospital death occurred in 4 patients (1%). Mean CK post procedure was 195±302 U/l.
Rotablation assisted angioplasty can be successfully realised by the radial route in the vast majority of cases with 6Fr guiding catheters with a very low rate of crossover to femoral access.
CORONARY: Atherectomy (excluding thrombectomy)