AIMS: Our aim was to examine procedural viability and midterm outcomes following the use of rotational atherectomy (RA) on malapposed, crippled, otherwise non-salvageable metallic stents (i.e., stentablation [SA]), and convey important procedural pointers for practitioners encountering such situations. METHODS AND RESULTS: Data on twelve SA subjects were analysed. The primary endpoint was procedural success: effective ablation of the malapposed stent and successful implantation of a new device. Major adverse cardiac events (MACE) and all-cause death at six months following the index procedure were examined as a secondary endpoint. All twelve patients underwent successful SA and novel stent implantation, with sufficient salvage of coronary anatomy (residual stenosis <30%). At six-month follow-up, however, MACE amounted to 50% and all-cause mortality to 25% in the inspected subjects. CONCLUSIONS: We found that, although feasible as an acute salvage option, SA distinctively increases post-procedural midterm MACE and mortality rates. This places emphasis on the importance of avoiding eventual SA situations, underlining the importance of ample lesion preparation prior to stent implantation.
AIMS: Our aim was to examine procedural viability and midterm outcomes following the use of rotational atherectomy (RA) on malapposed, crippled, otherwise non-salvageable metallic stents (i.e., stentablation [SA]), and convey important procedural pointers for practitioners encountering such situations. METHODS AND RESULTS: Data on twelve SA subjects were analysed. The primary endpoint was procedural success: effective ablation of the malapposed stent and successful implantation of a new device. Major adverse cardiac events (MACE) and all-cause death at six months following the index procedure were examined as a secondary endpoint. All twelve patients underwent successful SA and novel stent implantation, with sufficient salvage of coronary anatomy (residual stenosis <30%). At six-month follow-up, however, MACE amounted to 50% and all-cause mortality to 25% in the inspected subjects. CONCLUSIONS: We found that, although feasible as an acute salvage option, SA distinctively increases post-procedural midterm MACE and mortality rates. This places emphasis on the importance of avoiding eventual SA situations, underlining the importance of ample lesion preparation prior to stent implantation.
Authors: Wojciech Wańha; Mariusz Tomaniak; Piotr Wańczura; Jacek Bil; Rafał Januszek; Rafał Wolny; Maksymilian P Opolski; Łukasz Kuźma; Adam Janas; Tomasz Figatowski; Paweł Gąsior; Marek Milewski; Magda Roleder-Dylewska; Łukasz Lewicki; Jan Kulczycki; Adrian Włodarczak; Brunon Tomasiewicz; Sylwia Iwańczyk; Jerzy Sacha; Łukasz Koltowski; Miłosz Dziarmaga; Miłosz Jaguszewski; Paweł Kralisz; Bartosz Olajossy; Grzegorz Sobieszek; Krzysztof Dyrbuś; Mariusz Łebek; Grzegorz Smolka; Krzysztof Reczuch; Robert J Gil; Sławomir Dobrzycki; Piotr Kwiatkowski; Marcin Rogala; Mariusz Gąsior; Andrzej Ochała; Janusz Kochman; Adam Witkowski; Maciej Lesiak; Fabrizio D'Ascenzo; Stanisław Bartuś; Wojciech Wojakowski Journal: J Clin Med Date: 2022-03-23 Impact factor: 4.241