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1. Eight-Year Outcomes of Patients With Reduced Left Ventricular Ejection Fraction Who Underwent Transcatheter Aortic Valve Replacement With a Self-Expanding Bioprosthesis

Author

De Felice, Francesco, Paolucci, Luca, Musto, Carmine, Nazzaro, Marco Stefano, Chin, Diana, Stio, Rocco, Pennacchi, Mauro, Adamo, Marianna, Chizzola, Giuliano, Massussi, Mauro, Giannini, Cristina, Angelillis, Marco, De Carlo, Marco, Gorla, Riccardo, Bedogni, Francesco, Bellini, Barbara, Montorfano, Matteo, Bruschi, Giuseppe, Merlanti, Bruno, Ferrara, Erica, Poli, Arnaldo, Regazzoli, Damiano, Palmerini, Tullio, Iadanza, Alessandro, Nicolini, Elisa, Toselli, Marco, De Marco, Federico, and Gabrielli, Domenico

Published
2024
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2. Prevalence and outcome of elderly and low-risk patients with degenerative mitral regurgitation undergoing transcatheter edge-to-edge repair

Author

Loffi, Marco, Adamo, Marianna, Popolo Rubbio, Antonio, Pezzola, Elisa, Masiero, Giulia, Grasso, Carmelo, Denti, Paolo, Giordano, Arturo, De Marco, Federico, Bartorelli, Antonio L., Montorfano, Matteo, Godino, Cosmo, Baldi, Cesare, De Felice, Francesco, Mongiardo, Annalisa, Monteforte, Ida, Villa, Emmanuel, Giannini, Cristina, Crimi, Gabriele, Tusa, Maurizio, Testa, Luca, Radulescu, Crina I., Antonioli, Elena, Chizzola, Giuliano, Maisano, Francesco, Tarantini, Giuseppe, Tamburino, Corrado, Metra, Marco, and Bedogni, Francesco

Published
2024
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3. 2-year outcomes of MitraClip as a bridge to heart transplantation: The international MitraBridge registry

Author

Munafò, Andrea Raffaele, Scotti, Andrea, Estévez-Loureiro, Rodrigo, Adamo, Marianna, Hernàndez, Antonio Portolés, Peregrina, Estefanìa Fernàndez, Gutierrez, Lola, Taramasso, Maurizio, Fam, Neil P., Ho, Edwin C., Asgar, Anita, Vitrella, Giancarlo, Raineri, Claudia, Chizzola, Giuliano, Pezzola, Elisa, Le Ruz, Robin, Montalto, Claudio, Oreglia, Jacopo A., Fraccaro, Chiara, Giannini, Cristina, Fiorelli, Francesca, Rubbio, Antonio Popolo, Ooms, J.F., Compagnone, Miriam, Marcelli, Chiara, Maffeo, Diego, Bettari, Luca, Fürholz, Monika, Arzamendi, Dabit, Guerin, Patrice, Tamburino, Corrado, Petronio, A. Sonia, Grasso, Carmelo, Agricola, Eustachio, Van Mieghem, Nicolas M., Tarantini, Giuseppe, Praz, Fabien, Pascual, Isaac, Potena, Luciano, Colombo, Antonio, Maisano, Francesco, Metra, Marco, Margonato, Alberto, Crimi, Gabriele, Saia, Francesco, and Godino, Cosmo

Published
2023
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9. Ultrasound-Assisted, Catheter-Directed Thrombolysis for Acute Intermediate/High-Risk Pulmonary Embolism: Design of the Multicenter USAT IH-PE Registry and Preliminary Results

Author

Colombo, Claudia, primary, Capsoni, Nicolò, additional, Russo, Filippo, additional, Iannaccone, Mario, additional, Adamo, Marianna, additional, Viola, Giovanna, additional, Bossi, Ilaria Emanuela, additional, Villanova, Luca, additional, Tognola, Chiara, additional, Curci, Camilla, additional, Morelli, Francesco, additional, Guerrieri, Rossella, additional, Occhi, Lucia, additional, Chizzola, Giuliano, additional, Rampoldi, Antonio, additional, Musca, Francesco, additional, De Nittis, Giuseppe, additional, Galli, Mario, additional, Boccuzzi, Giacomo, additional, Savio, Daniele, additional, Bernasconi, Davide, additional, D’Angelo, Luciana, additional, Garascia, Andrea, additional, Chieffo, Alaide, additional, Montorfano, Matteo, additional, Oliva, Fabrizio, additional, and Sacco, Alice, additional

Published
2024
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10. Ultrasound-Assisted, Catheter-Directed Thrombolysis for Acute Intermediate/High Risk Pulmonary Embolism: Design of the Multicenter USAT IH-PE Registry and Preliminary Results

Author

Colombo, Claudia, primary, Capsoni, Nicolò, additional, Russo, Filippo, additional, Iannaccone, Mario, additional, Adamo, Marianna, additional, Viola, Giovanna, additional, Bossi, Ilaria Emanuela, additional, Villanova, Luca, additional, Tognola, Chiara, additional, Curci, Camilla, additional, Morelli, Francesco, additional, Guerrieri, Rossella, additional, Occhi, Lucia, additional, Chizzola, Giuliano, additional, Rampoldi, Antonio, additional, Musca, Francesco, additional, De Nittis, Giuseppe, additional, Galli, Mario, additional, Boccuzzi, Giacomo, additional, Savio, Daniele, additional, Bernasconi, Davide, additional, D’Angelo, Luciana, additional, Garascia, Andrea, additional, Chieffo, Alaide, additional, Montorfano, Matteo, additional, Oliva, Fabrizio, additional, and Sacco, Alice, additional

Published
2023
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11. Excimer Laser LEsion Modification to Expand Non-dilatable sTents: The ELLEMENT Registry

Author

Latib, Azeem, Takagi, Kensuke, Chizzola, Giuliano, Tobis, Jonathan, Ambrosini, Vittorio, Niccoli, Giampaolo, Sardella, Gennaro, DiSalvo, Maria Elena, Armigliato, Pietro, Valgimigli, Marco, Tarsia, Giandomenico, Gabrielli, Gabriele, Lazar, Lawrence, Maffeo, Diego, and Colombo, Antonio

Subjects
Bioengineering, Cardiovascular, Heart Disease, Heart Disease - Coronary Heart Disease, Atherosclerosis, Assistive Technology, Aged, Aged, 80 and over, Angioplasty, Balloon, Laser-Assisted, Contrast Media, Coronary Angiography, Coronary Restenosis, Coronary Stenosis, Coronary Thrombosis, Feasibility Studies, Female, Humans, Italy, Lasers, Excimer, Male, Middle Aged, Myocardial Infarction, Pilot Projects, Prospective Studies, Prosthesis Design, Registries, Stents, Time Factors, Treatment Outcome, Ultrasonography, Interventional, Vascular Calcification, In-stent restenosis, Excimer Laser Coronary Angioplasty, Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology
Abstract

Background/objectivesStent underexpansion is a risk factor for in-stent restenosis and stent thrombosis. Existing techniques to optimize stent expansion are sometimes ineffective. The aim of this study was to evaluate the effectiveness and feasibility of Excimer Laser Coronary Angioplasty (ELCA) in improving stent expansion when high-pressure non-compliant balloon inflation was ineffective.Methods and resultsECLA ablation was performed at high energy during contrast injection and only within the underexpanded stent. The primary endpoint of successful laser dilatation was defined as an increase of at least 1mm(2) in minimal stent cross-sectional area (MSA) on IVUS or an increase of at least 20% in minimal stent diameter (MSD) by QCA, following redilatation with the same non-compliant balloon that had been unsuccessful prior to ELCA. Secondary endpoints were cardiac death, myocardial infarction (MI) and target lesion revascularization. Between June 2009 and November 2011, 28 patients with an underexpanded stent despite high-pressure balloon inflation were included. The mean laser catheter size was 1.2±0.4 (range 0.9-2.0mm) and a mean of 62±12mJ/mm(2) at 62±21hertz were required for optimal expansion. Laser-assisted stent dilatation was successful in 27 cases (96.4%), with an improvement in MSD by QCA (1.6±0.6mm at baseline to 2.6±0.6mm post-procedure) and MSA by IVUS (3.5±1.1mm(2) to 7.1±1.9mm(2)). Periprocedural MI occurred in 7.1%, transient slow-flow in 3.6% and ST elevation in 3.6%. During follow-up, there were no MIs, there was 1 cardiac-death, and TLR occurred in 6.7%.ConclusionsThe ELLEMENT study confirms the feasibility of ELCA with contrast injection to improve stent underexpansion in undilatable stented lesions.

Published
2014

12. Prediction of mortality and heart failure hospitalisations in patients undergoing M-TEER: external validation of the COAPT risk score

Author

Adamo, Marianna, Rubbio, Antonio Popolo, Zaccone, Gregorio, Pighi, Michele, Massussi, Mauro, Tomasoni, Daniela, Pancaldi, Edoardo, Testa, Luca, Tusa, Maurizio B, De Marco, Federico, Giannini, Cristina, Grasso, Carmelo, De Felice, Francesco, Denti, Paolo, Godino, Cosmo, Mongiardo, Annalisa, Crimi, Gabriele, Villa, Emmanuel, Monteforte, Ida, Citro, Rodolfo, Giordano, Arturo, Bertorelli, Antonio L, Petronio, Anna Sonia, Chizzola, Giuliano, Tarantini, Giuseppe, Tamburino, Corrado, Bedogni, Francesco, and Metra, Marco

Subjects
Cardiology and Cardiovascular Medicine
Published
2023
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13. Excimer Laser LEsion Modification to Expand Non-dilatable sTents (The ELLEMENT Registry

Author

Lotih, Azeem, Takagi, Kensuke, Chizzola, Giuliano, Niccoli, Giampaolo, Ambrosini, Vittorio, Sardella, Gennaro, DiSalvo, Maria Elena, Armigliato, Pietro, Valgimigli, Marco, Tobis, Jonathan, Montorfano, Matteo, and Colombo, Antonio

Subjects
Cardiorespiratory Medicine and Haematology, Public Health and Health Services, Cardiovascular System & Hematology, Cardiovascular medicine and haematology
Published
2011

15. Mid‐term outcomes and hemodynamic performance of transcatheter aortic valve implantation in bicuspid aortic valve stenosis: Insights from the bicuSpid TAvi duraBILITY (STABILITY) registry

Author

Fiorina, Claudia, primary, Massussi, Mauro, additional, Ancona, Marco, additional, Montorfano, Matteo, additional, Petronio, Anna Sonia, additional, Tarantini, Giuseppe, additional, Castriota, Fausto, additional, Chizzola, Giuliano, additional, Costa, Giuliano, additional, Tamburino, Corrado, additional, and Adamo, Marianna, additional

Published
2023
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22. Deep learning to detect significant coronary artery disease from plain chest radiographs AI4CAD

Author

D'Ancona, Giuseppe, primary, Massussi, Mauro, additional, Savardi, Mattia, additional, Signoroni, Alberto, additional, Di Bacco, Lorenzo, additional, Farina, Davide, additional, Metra, Marco, additional, Maroldi, Roberto, additional, Muneretto, Claudio, additional, Ince, Hüseyin, additional, Costabile, Davide, additional, Murero, Monica, additional, Chizzola, Giuliano, additional, Curello, Salvatore, additional, and Benussi, Stefano, additional

Published
2023
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26. Ultrasound-assisted thrombolysis in high or intermediate-high risk pulmonary embolism patients with contraindications to systemic thrombolysis: A retrospective multicentre experience

Author

Russo, Filippo, primary, Cianfanelli, Lorenzo, additional, Chieffo, Alaide, additional, Galli, Mario, additional, Chizzola, Giuliano, additional, Bossi, Ilaria, additional, Capsoni, Nicolò, additional, Branca, Luca, additional, de Lorenzo, Leila, additional, Zaccone, Gregorio, additional, Ancona, Marco Bruno, additional, Guerrieri, Rossella, additional, and Montorfano, Matteo, additional

Published
2022
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30. Left ventricular reverse remodelling predicts long‐term outcomes in patients with functional mitral regurgitation undergoing MitraClip therapy: results from a multicentre registry

Author

Adamo, Marianna, primary, Godino, Cosmo, additional, Giannini, Cristina, additional, Scotti, Andrea, additional, Liga, Riccardo, additional, Curello, Salvatore, additional, Fiorina, Claudia, additional, Chiari, Ermanna, additional, Chizzola, Giuliano, additional, Abbenante, Alessandro, additional, Visco, Emanuele, additional, Branca, Luca, additional, Fiorelli, Francesca, additional, Agricola, Eustachio, additional, Stella, Stefano, additional, Lombardi, Carlo, additional, Colombo, Antonio, additional, Petronio, Anna Sonia, additional, Metra, Marco, additional, and Ettori, Federica, additional

Published
2018
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31. The paradox of clopidogrel use in patients with acute coronary syndromes and diabetes

Author

Ferlini, Marco, primary, Musumeci, Giuseppe, additional, Grieco, Niccolò, additional, Rossini, Roberta, additional, De Servi, Stefano, additional, Mafrici, Antonio, additional, Sponzilli, Carlo, additional, Demarchi, Andrea, additional, Assanelli, Emilio M., additional, Camisasca, Paola, additional, Chizzola, Giuliano, additional, Corrada, Elena, additional, Farina, Andrea, additional, Pedrinazzi, Claudio, additional, Lettieri, Corrado, additional, and Oltrona Visconti, Luigi, additional

Published
2018
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32. Self-expanding transcatheter aortic valve implantation for degenerated small Mitroflow bioprosthesis: early and midterm outcomes

Author

Adamo, Marianna, primary, Fiorina, Claudia, additional, Curello, Salvatore, additional, Chizzola, Giuliano, additional, Pezzotti, Elena, additional, Gavazzi, Emanuele, additional, Branca, Luca, additional, Chiari, Ermanna, additional, Quinzani, Filippo, additional, Rinaldi, Michele, additional, Metra, Marco, additional, and Ettori, Federica, additional

Published
2017
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34. Mitraclip therapy in patients with functional mitral regurgitation and missing leaflet coaptation: is it still an exclusion criterion?

Author

Adamo, Marianna, Chiari, Ermanna, Curello, Salvatore, Maiandi, Cristian, Chizzola, Giuliano, Fiorina, Claudia, Frontini, Mario, Cuminetti, Giovanni, Pezzotti, Elena, Rovetta, Riccardo, Lombardi, Carlo Mario, Manzato, Aldo, Metra, Marco, and Ettori, Federica

Subjects
Heart Valve Prosthesis Implantation, Male, Mitraclip implantation, Mitral Valve Insufficiency, Functional mitral regurgitation, Leaflet coaptation, Long-term outcome, Middle Aged, Surgical Instruments, Heart Valves, Treatment Outcome, Heart Valve Prosthesis, Humans, Mitral Valve, Female, Aged, Retrospective Studies
Abstract

The aim of this study was to investigate the feasibility, safety, and efficacy of Mitraclip therapy in patients with functional mitral regurgitation (MR) and missing leaflet coaptation (MLC).Out of 62 consecutive patients with functional MR undergoing Mitraclip implantation, 22 had MLC defined as the presence of a 'gap' between two mitral leaflets or insufficient coaptation length (2 mm), according to the EVEREST II criterion. Compared with the control group, the MLC population had a significantly higher effective regurgitant orifice area (0.67 ± 0.31 vs. 0.41 ± 0.13 cmThe Mitraclip procedure could be extended to patients with functional MR who do not fulfil the coaptation length EVEREST II criterion and who would otherwise be excluded from this treatment.

Published
2015

35. Drug-eluting stent use after coronary atherectomy

Author

Cortese, Bernardo, primary, Aranzulla, Tiziana C., additional, Godino, Cosmo, additional, Chizzola, Giuliano, additional, Zavalloni, Dennis, additional, Tavasci, Emanuela, additional, De Benedictis, Mauro, additional, Ettori, Federica, additional, Presbitero, Patrizia, additional, and Colombo, Antonio, additional

Published
2016
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36. Mitraclip therapy in patients with functional mitral regurgitation and missing leaflet coaptation: is it still an exclusion criterion?

Author

Adamo, Marianna, primary, Chiari, Ermanna, additional, Curello, Salvatore, additional, Maiandi, Cristian, additional, Chizzola, Giuliano, additional, Fiorina, Claudia, additional, Frontini, Mario, additional, Cuminetti, Giovanni, additional, Pezzotti, Elena, additional, Rovetta, Riccardo, additional, Lombardi, Carlo Mario, additional, Manzato, Aldo, additional, Metra, Marco, additional, and Ettori, Federica, additional

Published
2016
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37. Left ventricular reverse remodelling predicts long-term outcomes in patients with functional mitral regurgitation undergoing MitraClip therapy: results from a multicentre registry.

Author

Adamo, Marianna, Godino, Cosmo, Giannini, Cristina, Scotti, Andrea, Liga, Riccardo, Curello, Salvatore, Fiorina, Claudia, Chiari, Ermanna, Chizzola, Giuliano, Abbenante, Alessandro, Visco, Emanuele, Branca, Luca, Fiorelli, Francesca, Agricola, Eustachio, Stella, Stefano, Lombardi, Carlo, Colombo, Antonio, Petronio, Anna Sonia, Metra, Marco, and Ettori, Federica

Subjects
MITRAL valve insufficiency, VENTRICULAR remodeling, HEART failure, ELECTRONIC publications, LEFT heart ventricle, COMPARATIVE studies, ECHOCARDIOGRAPHY, HEART physiology, HEART ventricles, PROSTHETIC heart valves, LONGITUDINAL method, RESEARCH methodology, MEDICAL cooperation, PROGNOSIS, PROSTHETICS, RESEARCH, TIME, EVALUATION research, TREATMENT effectiveness, ACQUISITION of data, RETROSPECTIVE studies
Abstract

Aims: To explore whether left ventricular reverse remodelling (LVRR) is a predictor of outcomes in patients with functional mitral regurgitation (FMR) undergoing MitraClip procedure.Methods and Results: We analysed 184 consecutive patients with FMR who underwent successful MitraClip procedure. LVRR was defined as a reduction in left ventricular end-systolic volume ≥ 10% from baseline to 6 months. LVRR was observed in 79 (42.9%) patients. Compared with non-LVRR, LVRR patients were more likely to be females, less likely to have an ischaemic aetiology of mitral regurgitation or a prior (<6 months) heart failure (HF) hospitalization, and had smaller left ventricular dimensions. New York Heart Association class improved from baseline up to 1-year follow-up in both groups. Higher rates of overall survival (87.3% vs. 75.2%, P = 0.039), freedom from HF hospitalization (77.2% vs. 60%, P = 0.020), and freedom from the composite endpoint (cardiovascular mortality or HF hospitalization) (74.7% vs. 55.2%; P = 0.012) were observed in LVRR vs. non-LVRR patients at 2-year follow-up. LVRR was associated with a significant reduction of the adjusted relative risk of mortality, HF hospitalization and composite endpoint [hazard ratio (HR) 0.44; 95% confidence interval (CI) 0.20-0.96, P = 0.040; HR 0.55; 95% CI 0.32-0.97, P = 0.038; and HR 0.54; 95% CI 0.32-0.92, P = 0.023, respectively]. Female gender, absence of diabetes, freedom from prior HF hospitalization, non-ischaemic aetiology of mitral regurgitation, and left ventricular end-diastolic diameter < 75 mm were found to be independent predictors of LVRR.Conclusions: Left ventricular reverse remodelling is associated with better long-term outcomes in patients with FMR successfully treated with MitraClip. A careful patient selection may be useful as specific baseline features predict favourable left ventricular remodelling. [Correction added on 17 January 2019, after online publication: the preceding sentence has been changed.]. [ABSTRACT FROM AUTHOR]

Published
2019
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39. Complications of transcatheter aortic valve implantation

Author

Lorusso, Roberto, Gelsomino, Sandro, De Cicco, Giuseppe, Beghi, Cesare, Corradi, Domenico, Faggiano, Pompilio, Vizzardi, Enrico, D'Aloia, Antonio, Curello, Salvatore, Fiorina, Claudia, Chizzola, Giuliano, Frontini, Mario, and Ettori, Federica

Subjects
Medicine (all)
Published
2012

40. Role of different vascular approaches on transcatheter aortic valve implantation outcome

Author

Adamo, Marianna, primary, Fiorina, Claudia, additional, Curello, Salvatore, additional, Maffeo, Diego, additional, Chizzola, Giuliano, additional, Di Matteo, Gerardo, additional, Mastropierro, Rosa, additional, Nardi, Matilde, additional, Cervi, Edoardo, additional, De Cicco, Giuseppe, additional, Chiari, Ermanna, additional, Curnis, Antonio, additional, Bonardelli, Stefano, additional, Coletti, Giuseppe, additional, Manzato, Aldo, additional, Metra, Marco, additional, and Ettori, Federica, additional

Published
2015
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47. The combined use of Drug-eluting balloon and Excimer laser for coronary artery Restenosis In-Stent Treatment: The DERIST study

Author

Vittorio Ambrosini, Giuliano Chizzola, Guglielmo Bernardi, Gabriele Gabrielli, Pietro Armigliato, Pasquale Lisanti, Antonio Colombo, Marco Roberto, Luca Golino, Giampaolo Niccoli, Filippo Crea, Concetta De Paulis, Roberto Ceravolo, Ambrosini, Vittorio, Golino, Luca, Niccoli, Giampaolo, Roberto, Marco, Lisanti, Pasquale, Ceravolo, Roberto, Bernardi, Guglielmo, Armigliato, Pietro, Gabrielli, Gabriele, Chizzola, Giuliano, De Paulis, Concetta, Crea, Filippo, and Colombo, Antonio

Subjects
Coronary angiography, Male, Time Factors, medicine.medical_treatment, 030204 cardiovascular system & hematology, Balloon, Coronary Angiography, Cardiac Catheters, 0302 clinical medicine, Restenosis, Coated Materials, Biocompatible, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Excimer laser, General Medicine, Middle Aged, surgical procedures, operative, Treatment Outcome, Italy, Cardiology, Female, Lasers, Excimer, Stents, Radiology, Cardiology and Cardiovascular Medicine, Adult, medicine.medical_specialty, Angioplasty, Balloon, Laser-Assisted, In-stent restenosis (ISR), Coronary Restenosis, 03 medical and health sciences, Percutaneous Coronary Intervention, Internal medicine, Angioplasty, medicine, Humans, cardiovascular diseases, Drug Eluting Balloon (DEB), Excimer Laser Coronary Angioplasty (ELCA), Aged, business.industry, Stent, Percutaneous coronary intervention, medicine.disease, Case-Control Studies, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, business
Abstract

Aim Stents reduce angiographic restenosis in comparison with balloon angioplasty. The rate of in-stent restenosis (ISR), although less frequent than post-angioplasty restenosis, is becoming increasingly prevalent due to the recent exponential increase in the use of intracoronary stents. The aim of this study is to evaluate angiographic and clinical outcomes of PTCA in combination with the use of excimer laser coronary angioplasty (ELCA) and drug-eluting balloon (DEB) in treatment of in-stent restenosis (ISR). Methods and results This multi-centric case-control study evaluated angiographic and clinical outcomes of PTCA with excimer laser coronary angioplasty (ELCA) and drug-eluting balloon (DEB) in 80 patients with in-stent restenosis (ISR). All patients underwent nine months of clinical and a coronary angiography follow-up. This study showed clinical and angiographic long-term success in the 91% of the patients. The incidence of myocardial infarctions and deaths was lower than the rate after plain balloon angioplasty within the stent. Conclusions This study showed that excimer laser coronary angioplasty (ELCA) and drug-eluting balloon (DEB) may be an alternative treatment for in-stent restenosis (ISR).

Published
2017

48. Effects of drug-eluting stents after rotational atherectomy: evidence from a multicenter experience

Author

Antonio Colombo, Mauro De Benedictis, Bernardo Cortese, Davide Piraino, Federica Ettori, Cosmo Godino, Tiziana Claudia Aranzulla, Giuliano Chizzola, Cortese, Bernardo, Piraino, Davide, Godino, Cosmo, Aranzulla, Tiziana, Chizzola, Giuliano, Ettori, Federica, De Benedictis, Mauro, and Colombo, Antonio

Subjects
Registrie, Bare-metal stent, Atherectomy, Coronary, Male, Angiographic follow up, Percutaneous, Time Factors, Databases, Factual, Coronary Stenosi, medicine.medical_treatment, Coronary Artery Disease, 030204 cardiovascular system & hematology, Coronary Angiography, Atherectomy, Coronary artery disease, 0302 clinical medicine, Restenosis, Coronary Restenosi, Retrospective Studie, Drug-Eluting Stent, Stent, Medicine, 030212 general & internal medicine, Registries, Metal, Drug-Eluting Stents, General Medicine, Middle Aged, Treatment Outcome, Italy, Metals, Cardiology, Female, Stents, Cardiology and Cardiovascular Medicine, Human, medicine.medical_specialty, Time Factor, Prosthesis Design, Coronary Restenosis, 03 medical and health sciences, Percutaneous Coronary Intervention, Internal medicine, Humans, Aged, Retrospective Studies, business.industry, Coronary Stenosis, Percutaneous coronary intervention, Rotational atherectomy, Retrospective cohort study, medicine.disease, DES, business
Abstract

Aims Rotational atherectomy is used as an adjuvant tool for percutaneous coronary interventions, especially in case of highly calcific atherosclerotic plaques. Subsequent drug-eluting stent (DES) implantation is common; however, there is a paucity of clinical evidence to support this practice. Methods From the databases of four high-volume Italian centers, we analyzed the angiographic outcome of patients who underwent rotational atherectomy in native coronary vessels followed by DES or bare metal stent (BMS) implantation. Primary study endpoint was late lumen loss at the longest available follow-up. Other analyses consisted of the evaluation of in-stent percentage diameter stenosis, binary restenosis, major adverse cardiovascular events, and stent thrombosis at angiographic control. Results Between 2006 and 2011, 672 patients with 734 lesions treated had complete angiographic follow-up and were enrolled into this study; 385 lesions were treated with DES and 349 with BMS. The average follow-up length was 9 ± 5 months. Only a few significant differences regarding baseline clinical and angiographic characteristics were observed. Late lumen loss result significantly improved after DES implantation in comparison with BMS (0.54 ± 0.79 vs. 1.01 ± 1.13; P = 0.001), as well as in-stent percentage diameter stenosis (P = 0.01) and binary restenosis (P = 0.007). Major adverse cardiovascular events did not differ significantly, but showed an improved trend in the DES group, driven by a significantly lower target lesion revascularization (6.9 vs. 11.6%; P = 0.04). Conclusion In a cohort of patients treated with rotational atherectomy and with complete angiographic follow-up, DES implantation is associated with improved late lumen loss over BMS. However, the DES effect in terms of angiographic endpoints seems mitigated if compared to previous studies.

Published
2015

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