이달의 증례
| Effect of Operator Experience Performing Rotational Atherectomy on Clinical Outcomes After Percutaneous Coronary Intervention | |||
|---|---|---|---|
| 년도 | 2025년 8월 | ||
| 카테고리 | 이달의 kcj Hot Article | ||
| 저자 | Woochan Kwon, MD,1 Ki Hong Choi, MD, PhD,2 Young Bin Song, MD, PhD,2 Joo Myung Lee, MD, MPH, PhD,2 Taek Kyu Park, MD, PhD,2 Jeong Hoon Yang, MD, PhD,2 Joo-Yong Hahn, MD, PhD,2 Seung-Hyuk Choi, MD, PhD,2 Jae-Hwan Lee, MD, PhD,3 Min Chul Kim, MD, PhD,4 Hyun-Jong Lee, MD, PhD,5 and Hyeon-Cheol Gwon, MD, PhD2 | ||
| 소속 | 1 Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. 2 Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 3 Division of Cardiology, Department of Internal Medicine, Chungnam National University Sejong Hospital, Chungnam National University School of Medicine, Sejong, Korea. 4 Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea. 5 Division of Cardiology, Department of Medicine, Sejong General Hospital, Bucheon, Korea. |
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| 첨부파일 1 | KCJ-24-318 GA.jpg | ||
- 관리자
- 등록일 : 2025.07.30
- Hit 770
Background and Objectives
Rotational atherectomy (RA) is a technique used to ablate calcified plaques. There is speculation that operators’ experience with RA could play a role in the outcomes.
Methods
From December 2015 to April 2020, patients with calcified coronary lesions requiring percutaneous coronary intervention (PCI) with RA were enrolled in a prospective, multicenter, observational registry. The patients were divided into two groups based on the number of RAs performed by their operator in the past. A propensity score matching was done for a sensitivity analysis. The primary outcome was a composite of cardiac death, myocardial infarction, and target vessel revascularization at 1 year.
Results
A total of 497 patients were enrolled in the study. The calculated cutoff number of RA-PCI between the two groups was 82 cases. The more experienced group underwent PCI with less fluoroscopy time (less experienced vs. more experienced, 38.8 vs. 30.0 minutes, p<0.001), and more frequent intravascular imaging (54.6% vs. 69.0%, p=0.012). The primary outcome did not differ significantly between the groups (5.2% vs. 7.3%, hazard ratio, 1.46; 95% confidence interval [CI], 0.57–3.74; p=0.433). No significant difference in the incidence of complications was observed between the groups (5.5% vs. 7.0%, odds ratio, 1.38; 95% CI, 0.57–3.04; p=0.526). Similar results were observed in the propensity-score matched population.
Conclusions
In PCI using RA for calcified lesions, the composite outcome of cardiac death, myocardial infarction, and target vessel revascularization at 1 year was not significantly different according to RA experience among operators.
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