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To appreciate the efficacy and safety of rotational atherectomy via the transradial approach in the treatment of heavily calcified (ULMCA) unprotected left main lesions.
Thirty two patients with severely calcified ULMCA stenosis who were not eligible for (CABG)coronary artery bypass grafting were enrolled between January 2011 and July 2015. Procedural success rate and long-term major adverse cardiovascular events (MACE) including death, nonfatal myocardial infarction and target lesion revascularization(TLR) were evaluated.
Thirty two patients (25 males; mean age, 69±7 years;) with ULM stenosis were treated with rotational atherectomy(RA). Of these, 61.9% and 71.4% patients had diabetes and hypertation. The mean Euro SCORE and SYNTAX score was 5.4 and 37.2, respectively. The mean number of treated vessels was 2.56±0.91, no-reflow was observed in 4 patients during the procedure.
intra-aortic balloon pump was used in three cases. All 22 patients went through the operation successfully. The major events registered after the procedure included myocardial infarction in 1 patient, and access site bleeding in 4 patients. After a median of 10.9 (IQR 6.8-23.4) months of follow-up, 1 cardiac death was recorded. Survival free of cardiac death was 89.7±11% and target vessel revascularization 5.7±9% in one year.
Rotational atherectomy followed by stent implantation via transradial approach is feasible, effective and safe in patients with heavily calcified unprotected left main lesions.