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Document Details :

Title: Drug-eluting versus bare metal stents after rotational atherectomy: clinical outcome in a single centre
Author(s): R. Bielen , J. Bennett , B. Ferdinande , C. Dubois
Journal: Acta Cardiologica
Volume: 69    Issue: 6   Date: 2014   
Pages: 611-617
DOI: 10.2143/AC.69.6.1000003

Abstract :
Purpose: Heavily calcified atherosclerotic plaques can be prepared for stenting by rotational atherectomy (RA). Clinical outcomes with drug-eluting stents (DES) versus bare-metal stents (BMS) after RA have not been investigated sufficiently. We present a single-centre study comparing the efficacy and long-term outcome of DES versus BMS after RA.
Methods and results: We performed a retrospective cohort study of all patients who were treated with RA at our institution between January 2004 and March 2012. Clinical follow-up was obtained at 1 year. Procedural success (defined as a residual stenosis < 30%) was recorded, as was the 1-year incidence of myocardial infarction (MI), stent thrombosis (ST) and major adverse cardiac events (MACE), a composite end point of cardiac death, MI or target lesion revascularization (TLR). Eighty-five patients underwent RA followed by stenting, 30 receiving a BMS and 55 a DES, and completed 1-year clinical follow-up. Baseline clinical and angiographic characteristics were similar, and procedural success was achieved in 99% of the patients. At 1 year the overall incidence of MACE was 19%, and no significant differences in clinical outcome between DES and BMS were seen (MACE: 9 (16%) vs 7 (23%), P = 0.44; cardiac death: 3 (5%) vs 0 (0%); MI: 4 (7%) vs 5 (17%), P = 0.2; TLR: 2 (4%) vs 3 (10%), P = 0.25; ST: 2 (4%) vs 2 (7%), P = 0.52, respectively).
Conclusions: In this study, no significant differences in medium-term clinical outcomes between DES and BMS after RA were observed, although there was a definite trend to improved outcomes with DES.