Outcomes of rotational atherectomy followed by cutting balloon versus plain balloon before drug‐eluting stent implantation for calcified coronary lesions: A meta‐analysis

Mamas, Mamas A

Abstract

AbstractObjectiveThe aim of this study is to compare outcomes of rotational atherectomy and cutting balloon (RACB) versus rotational atherectomy and plain balloon (RAPB) before drug‐eluting stent (DES) implantation in calcified coronary lesions.MethodsRandomized controlled trials (RCT) and observational studies comparing RACB with RAPB were identified through a systematic search of published literature across multiple databases. Random effect meta‐analysis was performed to compare the outcome between the two groups.ResultsFour studies were included in the meta‐analysis (three observational and one RCT) involving a total of 315 patients. 166 patients had RACB, and 149 patients had RAPB before DES placement with a median follow‐up of 11.5 months. Compared with patients who had RAPB there was no difference in MACE (composite of death, myocardial infarction, and target vessel revascularization) (odds ratio [OR]: 0.74; 95% confidence interval [CI]: 0.25–2.18], slow flow/no reflow (OR: 0.71; 95% CI: 0.23–2.16), all‐cause mortality (OR: 2.02; 95% CI: 0.28–14.60), and device success rate (OR: 1.79; 95% CI: 0.28–11.18) in the RACB approach. There was a benefit towards less target lesion revascularization in the RACB group; however, this outcome was reported in two studies (OR: 0.29; 95% CI: 0.08–0.99). On meta‐regression there was no association between age, sex, diabetes, or lesion location with MACE and all‐cause mortality. The studies were homogenous across all outcomes.ConclusionRACB, as compared with RAPB, had a similar risk of MACE, all‐cause mortality, device success, and complication, but a lower risk of target lesion revascularization.

Citation

Mamas, M. A., Patel, N., Bandyopadhyay, D., Agarwal, G., Chakraborty, S., Kumar, A., …Naidu, S. S. (2022). Outcomes of rotational atherectomy followed by cutting balloon versus plain balloon before drug‐eluting stent implantation for calcified coronary lesions: A meta‐analysis. Catheterization and Cardiovascular Interventions, 99(6), 1741-1749. https://doi.org/10.1002/ccd.30159

• Journal Article Type: Article
• Acceptance Date: Mar 5, 2022
• Online Publication Date: Apr 2, 2022
• Publication Date: May 1, 2022
• Journal: Catheterization and Cardiovascular Interventions
• Print ISSN: 1522-1946
• Publisher: Wiley
• Volume: 99
• Issue: 6
• Pages: 1741-1749
• DOI: https://doi.org/10.1002/ccd.30159
• Keywords: Cardiology and Cardiovascular Medicine, Radiology, Nuclear Medicine and imaging, General Medicine
• Publisher URL: https://onlinelibrary.wiley.com/doi/10.1002/ccd.30159