Comparison of drug-eluting versus bare-metal stents after rotational atherectomy for the treatment of calcified coronary lesions

Abstract

Calcified coronary lesions are a well-known risk factor for short and long-term failure after both bare metal stent (BMS) [ 1 Tan K. Sulke N. Taub N. Sowton E. Clinical and lesion morphologic determinants of coronary angioplasty success and complications: current experience. J Am Coll Cardiol. 1995; 25: 855-865 Google Scholar , 2 Hoffmann R. Mintz G.S. Popma J.J. et al. Treatment of calcified coronary lesions with Palmaz–Schatz stents. An intravascular ultrasound study. Eur Heart J. 1998; 19: 1224-1231 Google Scholar ] and drug eluting stent (DES) implantation [ 3 Moussa I. Ellis S.G. Jones M. et al. Impact of coronary culprit lesion calcium in patients undergoing paclitaxel-eluting stent implantation (a TAXUS-IV sub study). Am J Cardiol. 2005; 96: 1242-1247 Google Scholar , 4 Berenguer A. Mainar V. Bordes P. Valencia J. Gomez S. Lozano T. Incidence and predictors of restenosis after sirolimus-eluting stent implantation in high-risk patients. Am Heart J. 2005; 150: 536-542 Google Scholar , 5 Migliorini A. Shehu M. Carrabba N. et al. Predictors of outcome after sirolimus-eluting stent implantation for complex in-stent restenosis. Am J Cardiol. 2005; 96: 1110-1112 Google Scholar ]. Rotational atherectomy facilitates the delivery of stents in severely calcified coronary lesions by modifying plaque anatomy and smoothing inner vascular lumen. Recent reports suggest that the use of rotational atherectomy in combination with DES implantation for the treatment of severely calcified lesions might result in high procedural success and acceptable restenosis rate [ 6 Clavijo L.C. Steinberg D.H. Torguson R. et al. Sirolimus-eluting stents and calcified coronary lesions: clinical outcomes of patients treated with and without rotational atherectomy. Catheter Cardiovasc Interv. 2006; 68: 873-878 Google Scholar , 7 Garcia de Lara J. Pinar E. Ramon Gimeno J. et al. Percutaneous coronary intervention in heavily calcified lesions using rotational atherectomy and paclitaxel-eluting stents: outcomes at one year. Rev Esp Cardiol. 2010; 63: 107-110 Google Scholar , 8 Furuichi S. Sangiorgi G.M. Godino C. et al. Rotational atherectomy followed by drug-eluting stent implantation in calcified coronary lesions. EuroIntervention. 2009; 5: 370-374 Google Scholar , 9 Mezilis N. Dardas P. Ninios V. Tsikaderis D. Rotablation in the drug eluting era: immediate and long-term results from a single center experience. J Interv Cardiol. 2010; 23: 249-253 Google Scholar , 10 Benezet J. de la Llera LS Diaz Cubero J.M. Villa M. Fernandez-Quero M. Sanchez-Gonzalez A. Drug-eluting stents following rotational atherectomy for heavily calcified coronary lesions: long-term clinical outcomes. J Invasive Cardiol. 2011; 23: 28-32 Google Scholar ]. However, the long-term efficacy and safety of DES compared to BMS, in combination with rotational atherectomy in patients with calcified coronary lesions is limited.