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Introduction: The availability of rotational atherectomy (RA) has recently increased in Poland, which was followed by an increase in the rate of RA procedures and catheterization laboratories performing RA. Aim: To assess current trends regarding the rapid increase in the number of RA procedures and catheterization laboratories performing RA. Material an methods: We analyzed patients treated with percutaneous coronary intervention (PCI) in the years 2014-2017 available in the nationwide ORPKI dataset. From the overall 431,467 patients treated with PCI, we extracted 1,873 treated with RA. We analyzed the relationship between frequency of RA usage, its distribution between low and high volume centers and procedural outcomes, procedural-related complications and the PCI effectiveness expressed as the target vessel patency rate after PCI. Results: The number of RA procedures increased from 181 in 2014 (0.19%) to 698 in 2017 (0.61%), with an over two-fold increase in the number of catheterization laboratories performing RA from 25 (15.5%) in 2014 to 55 (34.1%) in 2017. Besides the fact that patient characteristics have changed in the most recent years, the rate of procedural success expressed as procedure-related complications remained stable in the 3 years 2015-2017 and was around 3%, while the procedural effectiveness expressed as patent target coronary artery after PCI was stable and over 98% in all of the analyzed years. Conclusions: Along with the increasing number of RA procedures and catheterization laboratories performing RA in Poland, the procedural effectiveness remained stable during an observational period of 4 years. [ABSTRACT FROM AUTHOR]

A case study of a 67-year-old woman diagnosed with non ST-segment elevation myocardial infarction is presented. It mentions that coronary angiography revealed critical in-stent restenosis in the calcified left main coronary artery (LMCA) with diffuse non-significant changes in the left anterior descending artery (LAD). It also recommends treatment of percutaneous coronary intervention (PCI) through coronary artery bypass grafting (CABG).

Data on the clinical outcomes comparing synthetic fluorocarbon polymer polytetrafluoroethylene- (PTFE, GraftMaster) and polyurethane- (Papyrus) covered stents (CSs) to seal coronary artery perforations (CAPs) are limited. We aimed to evaluate 30-day and 1-year clinical outcomes after PCI complicated by CAP and treated with CS. We assessed 106 consecutive patients with successful CAP sealing (122 CSs): GraftMaster (51 patients, 57 CSs) or Papyrus CS (55 patients, 65 CSs). The primary endpoint was the occurrence of major adverse cardiac events (MACE), defined as the composite of cardiac death, target lesion revascularisation (TLR), and myocardial infarction (MI). The mean age of subjects was 69 ± 9.6 years (53.8% males). No significant differences were identified between the GraftMaster and Papyrus groups at the 30-day follow-up for MACE, cardiac death, MI and stent thrombosis (ST), while significantly lower rate of TLR and TVR (p = 0.02) were confirmed in the Papyrus group. At one year, differences remained similar between stents for MACE, a trend towards a lower rate of TLR (p = 0.07), MI (p = 0.08), and ST (p = 0.08), and higher for cardiac death (p = 0.07) was observed in the Papyrus group. This real-life registry of CAP illustrated that the use of Papyrus CS is associated with lower rates of TLR and TVR at 30-day follow-up in comparison to the GraftMaster CSs and no significant differences between both assessed CS at one year of follow-up. [ABSTRACT FROM AUTHOR]