Comparison of the incidence of slow flow after rotational atherectomy with IVUS-crossable versus IVUS-uncrossable calcified lesions

Although the usefulness of intravascular ultrasound (IVUS) in rotational atherectomy (RA) has been widely recognized, an IVUS catheter may not cross the target lesion because of severe calcification. The aim of this study was to compare the incidence of slow flow following RA between IVUS-crossable...

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Autores principales: Sakakura, Kenichi, Taniguchi, Yousuke, Yamamoto, Kei, Tsukui, Takunori, Seguchi, Masaru, Wada, Hiroshi, Momomura, Shin-ichi, Fujita, Hideo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2020
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7347912/
https://www.ncbi.nlm.nih.gov/pubmed/32647194
http://dx.doi.org/10.1038/s41598-020-68361-z
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author Sakakura, Kenichi
Taniguchi, Yousuke
Yamamoto, Kei
Tsukui, Takunori
Seguchi, Masaru
Wada, Hiroshi
Momomura, Shin-ichi
Fujita, Hideo
author_facet Sakakura, Kenichi
Taniguchi, Yousuke
Yamamoto, Kei
Tsukui, Takunori
Seguchi, Masaru
Wada, Hiroshi
Momomura, Shin-ichi
Fujita, Hideo
author_sort Sakakura, Kenichi
collection PubMed
description Although the usefulness of intravascular ultrasound (IVUS) in rotational atherectomy (RA) has been widely recognized, an IVUS catheter may not cross the target lesion because of severe calcification. The aim of this study was to compare the incidence of slow flow following RA between IVUS-crossable versus IVUS-uncrossable calcified lesions. We included 284 RA lesions, and divided into an IVUS-crossable group (n = 150) and an IVUS-uncrossable group (n = 134). The primary endpoint was slow flow just after RA. The incidence of slow flow (TIMI flow grade ≤ 2) was significantly greater in the IVUS-uncrossable group than in the IVUS-crossable group (26.1% vs. 10.7%, p = 0.001). The incidence of severe slow flow (TIMI grade ≤ 1) was also greater in the IVUS-uncrossable group than in the IVUS-crossable group (9.7% vs. 2.7%, p = 0.022). The multivariate logistic regression model showed a significant association between slow flow and pre-IVUS uncrossed lesions (vs. crossed lesions: odds ratio 2.103, 95% confidence interval 1.047–4.225, p = 0.037). In conclusion, the incidence of slow flow/severe slow flow just after RA was significantly greater in the IVUS-uncrossable lesions than in the IVUS-crossable lesions. Our study suggests the possibility that the IVUS-crossability can be used as a risk stratification of severe calcified lesions.
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spelling pubmed-73479122020-07-14 Comparison of the incidence of slow flow after rotational atherectomy with IVUS-crossable versus IVUS-uncrossable calcified lesions Sakakura, Kenichi Taniguchi, Yousuke Yamamoto, Kei Tsukui, Takunori Seguchi, Masaru Wada, Hiroshi Momomura, Shin-ichi Fujita, Hideo Sci Rep Article Although the usefulness of intravascular ultrasound (IVUS) in rotational atherectomy (RA) has been widely recognized, an IVUS catheter may not cross the target lesion because of severe calcification. The aim of this study was to compare the incidence of slow flow following RA between IVUS-crossable versus IVUS-uncrossable calcified lesions. We included 284 RA lesions, and divided into an IVUS-crossable group (n = 150) and an IVUS-uncrossable group (n = 134). The primary endpoint was slow flow just after RA. The incidence of slow flow (TIMI flow grade ≤ 2) was significantly greater in the IVUS-uncrossable group than in the IVUS-crossable group (26.1% vs. 10.7%, p = 0.001). The incidence of severe slow flow (TIMI grade ≤ 1) was also greater in the IVUS-uncrossable group than in the IVUS-crossable group (9.7% vs. 2.7%, p = 0.022). The multivariate logistic regression model showed a significant association between slow flow and pre-IVUS uncrossed lesions (vs. crossed lesions: odds ratio 2.103, 95% confidence interval 1.047–4.225, p = 0.037). In conclusion, the incidence of slow flow/severe slow flow just after RA was significantly greater in the IVUS-uncrossable lesions than in the IVUS-crossable lesions. Our study suggests the possibility that the IVUS-crossability can be used as a risk stratification of severe calcified lesions. Nature Publishing Group UK 2020-07-09 /pmc/articles/PMC7347912/ /pubmed/32647194 http://dx.doi.org/10.1038/s41598-020-68361-z Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Sakakura, Kenichi
Taniguchi, Yousuke
Yamamoto, Kei
Tsukui, Takunori
Seguchi, Masaru
Wada, Hiroshi
Momomura, Shin-ichi
Fujita, Hideo
Comparison of the incidence of slow flow after rotational atherectomy with IVUS-crossable versus IVUS-uncrossable calcified lesions
title Comparison of the incidence of slow flow after rotational atherectomy with IVUS-crossable versus IVUS-uncrossable calcified lesions
title_full Comparison of the incidence of slow flow after rotational atherectomy with IVUS-crossable versus IVUS-uncrossable calcified lesions
title_fullStr Comparison of the incidence of slow flow after rotational atherectomy with IVUS-crossable versus IVUS-uncrossable calcified lesions
title_full_unstemmed Comparison of the incidence of slow flow after rotational atherectomy with IVUS-crossable versus IVUS-uncrossable calcified lesions
title_short Comparison of the incidence of slow flow after rotational atherectomy with IVUS-crossable versus IVUS-uncrossable calcified lesions
title_sort comparison of the incidence of slow flow after rotational atherectomy with ivus-crossable versus ivus-uncrossable calcified lesions
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7347912/
https://www.ncbi.nlm.nih.gov/pubmed/32647194
http://dx.doi.org/10.1038/s41598-020-68361-z
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